Value Based Care from the Patient Perspective
Updated: Feb 22, 2021
Health care is filled with waste resulting in non-value based care. This is care that provides little benefit to patients with potential harm and unnecessary cost. The cost estimate of this is over $345 billion annually in wasteful health spending.
“Most American businesses have delivered substantial profits pursuing their customers needs with an obsession.Health care originates from a delivery system of “parental culture”, where physicians equipped with diagnostic knowledge made the decisions on the patient’s behalf.”
Today, physicians are pressured from payor bureaucracy, malpractice, patient medical complexity and simply have a lack of time. This has created a system filled with wasteful care not benefiting patients.
Physician clinical decisions leading to inappropriate care can expose patients to harm. For example, the medical community has voiced concerns about unnecessary admissions to the hospital. Estimates report 4% of inpatients experience a serious harm secondary to preventable error. New studies demonstrate a significant variation in admission rates among Emergency Physicians when controlling for patient conditions.
Patients expect care to be predicated on information with delivery of treatments being both accurate and precise. Do we believe they find acceptable a system where they are admitted to a hospital when seeing one physician on a Tuesday, but under the very same circumstance discharged on a Wednesday?
Frequently, my patients in the ED have had many conflicting interactions with physicians and staff during their care journey. They may have called a nurse triage line, then persuaded their headache could be a life-threatening condition, go with all urgency to the ED. Upon their arrival to the department a triage nurse may message this headache is not as important compared to needs of others waiting, resulting in a 4 hour wait to be seen by a physician, for a symptom that had raised a great deal of alarm with the triage nurse just moments earlier.
Right care, right place, right time is a powerful slogan empowered with a patient centric view to the care journey. Now is the time to ensure patients are empowered in our health care system to achieve their desired outcome. And that all the complicated moving parts of our health systems support them to achieve their definition of success.
