Hope for the Healthcare System?

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October 25, 6:25 PM

by Dr. Delia Chiaramonte, Baltimore Health Examiner

 

 

As doctors often do, I was grousing about the state of the healthcare system with a colleague, family physician Adam Dimitrov. He told me the story of a recent patient encounter and he shared his enthusiasm and commitment to changing our disordered healthcare system. Today I am hopeful that our system can be healed.

Dr. Dimitrov saw this patient at home because his multiple, chronic illnesses don’t fit tidily into the standard 15 minute office visit. But it wasn’t simply the extra time and convenience that made this appointment special. With eight family members and four generations present, Dr. Dimitrov got a window into this patient’s world that was hidden during visits to the office. He saw how long his patient struggled to get down the stairs and how challenged his wife was to care for him, yet he also saw how much the patient’s family rallied around him. As Dr. Dimitrov was leaving, his patient said “I love you” with tears in his eyes.

Everyone was moved.

This experience doesn’t even resemble the rushed, sterile, clinical encounters that epitomize most modern healthcare visits. Why did this patient get so lucky? Was it simply because he happened upon an exceptional doctor?

It is much more complicated than that.

Many doctors begin their careers as idealistic and empathetic go-getters. They notice their cynical, burned-out attendings, and feel certain that they will never travel that path. They are hopeful and enthusiastic and they look forward to a lifetime of close relationships with their patients. But the stresses of 15 minute office visits, frustrated patients, endless insurance paperwork, and poorly functioning offices sneak up on them. As patients become more health savvy, and thus more demanding, their expectations of their doctors increase. Yet doctors are functioning in a dysfunctional system and they are often unable to provide the kind of care that they once dreamed of – the kind of care that their patients expect and deserve. They simply cannot provide optimal care to those who need it most.

So what can be done?

Some physicians, myself included, have tried alternative practice models to squeeze out more time for patients. Concierge and patient advocacy practices are growing, but it isn’t clear yet that this will be the answer. These models require a financial contribution from the patient, and many patients are either unable or unwilling to pay for these extras.

I don’t always feel hopeful that my profession can return to its former glory, but today Dr. Dimitrov gave me hope. He is an emerging leader in the field of healthcare reform and he and his colleagues have plans to recreate a healthcare system that truly serves the needs of both patients and physicians. As a member of the host committee for the 2008 Society of Teachers of Family Medicine Meeting that will be at the Baltimore Convention Center next weekend, Dr. Dimitrov has helped bring together scholarly leaders to hash out solutions to these unendingly complicated problems. As they discuss our current healthcare crisis, with each other and with targeted community leaders, and tackle issues such as practice redesign and access to care, I hope that they can begin to move us closer to a system that works.

With such motivated, bright, dedicated people on the case there has to be hope for the future of my profession. There just has to be hope.

Right?

Dr. C.
www.insightmedicalconsultants.com

(AP Photo)

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