Friday, April 8, 2011

Good vs. Fast – When it Comes to Your Care, What Matters Most?

As a society, we have gotten used to having access to the things we need, often instant access, thanks to technology and the digital revolution. Think of all of the services you deal with every day and all of the people you utilize to get through your week. What if the dry cleaner wasn’t open on Saturdays or the supermarket closed at 5 p.m. during the week? How would this limited access affect how you go about your daily lives?
Access is one of the major issues we face as we move into this new era of healthcare reform. And while many people still aren’t sure what healthcare reform or terms like medical home mean to them as individuals, they do know that they need access to care. Knowing that your usual source of healthcare (e.g. your primary care physician) is there for you and your family is of utmost importance, which is why extended hours and being able to make an appointment with your physician at 7:30 a.m. or 7:00 p.m. is so important.
At a recent Town Hall meeting, one of our colleagues explained to me how good her experience had been at a “medical care drop-in at a store” site (You know the company that I mean). I said, “It was fast,” and she said, “No, it was good. I didn’t say fast…”  She was right, I said it was fast because I was trying to point out that if you’re given a choice of 1) not being seen at all because the physician or group who knows you is not available; 2) going and sitting in the waiting room of an Emergency Department for something that isn’t an emergency; or 3) going to a place where someone you don’t know will care for you quickly, of course you’ll go for the quick scenario. But isn’t it better to see a physician or a team member who actually knows you and has your medical records, as well as be seen expeditiously? That’s what we’re building and that’s what will make the new GBMC HealthCare system different. At the “medical care drop-in at a store” facility, it’s not about the patient. If it were about the patient, it would be a reliable source of ongoing, integrated care, not episodic care.
In this country, we do episodic pretty well, but for chronic disease, episodic care just doesn’t cut it. We need to build continuous, reliable, integrated, caring and connected care – it’s virtually impossible to be connected to a system or a provider that you don’t know and that doesn’t know you.   I truly believe that what people want is the best possible health outcomes with the greatest patient experience and this can be achieved with integrated care and access. This is the direction we need to move in to address the overall wellness of our community for the future.
We are building good and fast!
We at GBMC must put all of our efforts into making a better healthcare system. It is also true however, that at some point individuals need to be better consumers. People will need to become better at looking out for their own health, and better at questioning the expected value of the care they are receiving.
What kind of healthcare consumer are you? Do you go for quick and easy or are you more concerned with receiving care from a provider with whom you have a relationship and who knows your medical history?


  1. Another disgruntled GBMC patientApril 8, 2011 at 1:37 PM

    Mr. C,

    You make some excellent points.

    However, as a recent patient at GBMC's Emergency Room and as a recent patient at Patient First, I must respectfully disagree.

    Several weeks ago, a family member of mine was rushed to the ER at GBMC. We waited SEVEN hours to essentially be told the staff there had no idea what was ailing her. Waiting in the ER there, I felt like I was in the Twilight Zone. And we weren't the only ones to experience this problem. Other patients' families were frustrated, confused, and exhausted after having to wait several hours to even be seen. It was enough for me to WAY!

    However, I had a similar experience at Patient First, and the care there was exceptional. The doctors were kind and friendly, the staff was very attentive, and my entire experience there - from start to finish - last no more than 45 minutes. Most importantly, I was healed from my sickness due to a quick, rapid diagnosis and treatment.

    Conversely, the family member I mentioned earlier is still waiting for her complete diagnosis from GBMC's staff. After three follow ups at GBMC, nothing conclusive has been determined. Fortunately, the symptoms went away and she's much better now.

    And let's not even get into the cost. A $689 bill came to us for the blood work and tests my family member received at GBMC.

    For me, who also had blood work and several tests completed at Patient First??? Nothing. My $15 copay cover it all.

    Frankly, my family member's experience at GBMC was neither good or fast. In fact, it was the exact opposite: incompetent and very slow.

  2. @Another disgruntled GBMC patient-
    You make some excellent points when it comes to the excess wait at the ER and the absurd amount of money it may cost to go there. Patient First is an excellent option for a patient who is looking for a quick and simple visit. Whereas the ER is a little bit of a different setup.
    I will point out that all of the serious emergencies Ive witnessed at the ER have been handled extremely quickly and by a staff of nurses who have a strong "gut" instinct.

  3. Let me respond first to "another disgruntled patient". I am very sorry that your family member's experience at our Emergency Department had a lot of opportunity for improvement. We are working to make things better. I would like to ask you why your family member didn't go to the fast place? I think I know the answer, its probably because the family realized that the fast place can only deal with medical problems that are not very difficult. If our staff spent 7 hours investigating something and didn't find a clear diagnosis, it sounds like the patient may have been better off going to a physician who knew him or her and would have his or her records. It sounds like a complex problem.

    As I said in my blog, we are building a better healthcare system for our patients at GBMC. We want the patient to be able to be seen by the team of doctors and nurses that knows him or her when the need arises. We want to have a wonderful option for patients so they won't go to the Emergency Department with non-Emergencies or chronic problems that take up a lot of time of our Emergency Team.

    I am very greatful for our ED staff for dealing with all of the patients who come until we can rebuild the system.

    By July first, all of the GBMA primary care sites will be open 7am to 7pm. We will not use the Emergency Department as the "path of least resistance" and our patients will get better health and better care.

  4. Let me also thank anonymous for pointing out that when people come to our ED with true emergencies that people get outstanding care.

    We all need to ask ourselves about the value of the care that we are receiving. One very important question should be "Do I really need this antibiotic ?" We have created supergerms though our misuse of antibiotics in this country. Now, some of the bacteria that we need to treat are resistant to all of the antibiotics that we have. Again, fast may or may not really be good. We are building fast and good.

  5. Some hospitals have a Patient First close by, if not on, their campuses. Why don't we form a partnership with them? Seems like that would alleviate the ED pressure.

  6. Thanks, Anonymous. We want to have the equivalent of 5 or more "patients truly first" on our campus by July. They will be all of our primary care offices on campus that will not say no when you call and will be open from 7am until 7pm at least on weekdays to start.

    What happens now with your primary care doc if you call with an urgent need? Is your primary care office now open until 7pm? Can they accomodate you the same day that you call?


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