Is Medical Accountability a Thing of the Past?
One of the byproducts of the ever-expanding healthcare industry in the United States is a much higher degree of complexity. This is especially true when it comes to the patient-doctor relationship. Whereas a patient used to be treated by one doctor, they now may be given medical care by a long line of professionals. The changes in the medical field also come with the need for better communication between healthcare providers and raise a central question of accountability. Who is ultimately responsible for the patient’s well-being? In a world where physicians are increasingly segmented and isolated from one another in terms of communication and treatment offered, it can be the people receiving the healthcare who get lost in the shuffle. Some Key Points to Remember
- Over 80 percent of adults, and over 90 percent of children will see a healthcare professional every year, according to the Centers for Disease Control and Prevention.
- The demand for primary care physicians is outpacing the supply, with the projected shortfall to be 20,400 primary care physicians by the year 2020. This is especially true in rural America, according to the Health Resources and Services Administration.
- In 2010, less than one-third of physicians specialize in primary care, according to research commissioned by the Agency for Healthcare Research and Quality.
Providing Healthcare is Now a Team Sport In the 1940s, general practitioners accounted for a large majority of all doctors, some estimates say around three-fourths of doctors at that time were general practitioners. Today, they are but a fraction of physicians. While specialization is a good thing for patients, overspecialization is not. For many different reasons, doctors are more specialized now than they have ever been before. When a patient has a serious, chronic medical problem, the system that they must pass through to receive their care is incredibly inefficient, convoluted and costly. Overspecialization is a major contributing factor to this problem. Patients with multiple medical conditions are often met with an extremely high number of referrals and treated by doctors who are in the dark about what other kinds of care that patient receives and how his or her other treatments or medications might conflict with the treatment they are providing. The costs incurred by patients for this inefficient system is one of the factors in the high cost of healthcare in the United States, and one of the reasons that people who suffer from serious medical conditions can be financially crippled by medical bills. What Is in The Best Interests of Patients? Patients are often given tests and treatments that they don’t need, sometimes at the expense of tests and treatments that they desperately do need. The overspecialization of physicians and the complexity of the system means that patients are frequently handed from one doctor or department to another without adequate communication between these entities. Again, this problem is most harmful to patients who are the sickest – those with multiple chronic diseases. Estimates say that nearly one-quarter of our population have multiple chronic conditions and account for roughly 65 percent of our nation’s healthcare expenditures. As the Atlantic points out, by the time the average person reaches the age of 65, they will have two or more chronic diseases. If they are in poverty, the average person will have two or more chronic diseases sooner, by the age of 55. Patients who have multiple chronic diseases need to have coordinated, streamlined care in order to make sure they are treated and tested properly and to keep wasted costs to a minimum — both on the part of medical facilities and, more importantly, on the part of the patients. The reality of our healthcare system is that no one is in charge of coordinating or overseeing this care. The Importance of Communication and Transparency In order to address the problems that face our healthcare system, a few guiding principles should be made the top priority. The first of these is communication. Communication breakdowns were listed by a Johns Hopkins study as one of the key contributors to a large number of medical errors in the United States. Miscommunication can lead to surgical errors, medication errors, mistreatment and misdiagnosis of patients, as well as other consequences. Transparency is another key aspect of improving our current system. Part of this is the ability of medical facilities to see how other healthcare providers are treating patients, and another part is the ability of patients to see and understand what goes into their tests and treatments. Healthcare providers want this, too. Better-informed patients are key to better healthcare and make the job of doctors less challenging. Patients with multiple chronic diseases are also in dire need of coordinated treatment. When doctors don’t know what other healthcare providers have done and how that impacts the care they provide a patient, there is a likelihood that the treatment will have an inadequate, if not detrimental, impact on patients. Streamlining the process and providing a single patient’s care with oversight will save time and resources for all of those involved. Who is Responsible for the Care of a Patient? As it currently stands, several physicians and medical facilities provide care for individuals who suffer from multiple chronic conditions, but these entities don’t always work with each other in a way that is in the best interest of the patient. Electronic medical records were intended to address some of these shortcomings, but they have added many problems into the mix. A single typo or an omitted word can have massive consequences for patients, and these systems have caused headaches for medical professionals and costly medical mistakes for patients. We have more forms of treatment, tests and specialties in the medical field than we have ever had before. Add to that a growing problem of patients with multiple chronic diseases and the result is a system in which miscommunication, error, and uncoordinated care are commonplace. This is not a desirable situation for doctors, nurses, insurers and, especially, patients. We all want progress and medical innovation, but the decentralization and lack of oversight of a patient’s care is proving to be harmful to patients, providers and the incredible costs of healthcare in the United States.