This isn’t going to be a lengthy post. This isn’t a post about the Affordable Care Act. This isn’t a post about President Obama. Nope, this post is much simpler than all of that.
This post is about putting the “care” back in healthcare.
Now then, before I go any further I should tell you that I actually do like my primary care physician. In fact, if I didn’t like this physician I’d have been gone long ago because I find the Community Health Network a maddening and non-user friendly experience despite their efforts to develop electronic records and to tie all of their various campuses and networks together.
Community Health Network is a Central Indiana based network of hospitals, clinics, pavilions, etc. with over 200 sites of care throughout Central Indiana. It has been recognized for its integrated health system and, indeed, its computer network is impressive and has helped me hang on for as long as I have given my own physician’s comfort with technology and its utilization as part of primary care.
From its own website, Community Health Network labels itself as “Central Indiana’s leader in providing convenient access to exceptional healthcare services, where and when patients need them—in hospitals, health pavilions and doctor’s offices, as well as workplaces, schools and homes.”
Now then, this is complete crap.
As someone who has played a central role in planting a web-based church, I wholeheartedly believe in the power of technology to create networks, increase efficiency, improve lives, and create another vehicle through which we can reach out and help people who all too often fall through the cracks. However, when we allow technology to dominate our systems of care we have failed those we serve. When we allow our structures to dictate how we serve, then we’ve removed the “care” from healthcare.
Unfortunately, it seems as if this is the direction that Community Health Network is heading.
A few years ago, or not long after I started working for my current employer, I decided it was time to get re-established with a healthcare network having mostly gotten by for years with occasional visits to specialists and, to be honest, spending more time responding to crises than actually investing myself in preventative care. As an adult born with spina bifida and also being a double amputee/paraplegic with a mild brain injury, I’d long ago given up on the idea of maintaining my healthcare like I did in the days I was on Social Security Disability. I spent nearly 10 years after college graduation working for an inner city hospital that was a wonderful employer yet not exactly equipped to deal with serious health issues like my own, but having gone from life on Disability to life among the employed and utilizing commercial insurance I’d quickly figured out that it was nearly impossible to balance fiscal responsibility and meeting my healthcare needs. So, for many years I just sort of got by and did the best I could.
While Community Health Network isn’t exactly known for its work with birth defects, an initial meeting with a former doctor impressed me enough that I decided I would go with her practice and maintain myself within this healthcare network for as long as I could or until such time as I truly needed expertise in spina bifida. After 2-3 years, this originally chosen physician left the practice and I was “assigned” to a new doctor within the practice.
I was skeptical, but I have to be honest and say I instantly found her to be fantastic. While she wasn’t exactly familiar with spina bifida, I was impressed with her openness and her comfort with the knowledge that she did possess. Like me, she possesses a quiet humor and bluntness that simply works well with this jaded, burned out on healthcare soul. She initially struck me as overly cautious, but over our first few months we simply clicked and I thought “Okay, this is a doctor I can really work with.”
I even found myself appreciating the fact that Community Health Network was growing into its utilization of electronic records, a utilization that created opportunities to actually connect with your physician (or their nurse) when it was needed. This computer network also makes it possible to better manage one’s own health records, keep track of labs, keep track of medications, pay bills, and much more. I found myself hopeful that this network would improve an already positive working relationship with my physician.
Now then, I have to be honest and say that I don’t completely understand how the entire electronic network ties together, but over the past few months it has become apparent that it is fractured, non-communicative, and rapidly causing a decline in the personalization that I have valued so highly from my physician and her practice.
When I message my physician through the network, I can most certainly still get a response and she continues to respond in a way that is respectful of my situation. Yet, and I may be wrong, it feels as if the network itself has been divided into different points of entry for different concerns.
I find myself wondering “When I send a message to get an appointment, do I even get the office? Do I get a different office that now handles scheduling concerns?” It’s not completely clear, but it’s VERY clear that they do not know me and they are more concerned with structure than service.
It seems like, and again I may be wrong, when I send anything from the various options available through their computer network that it goes to a different area and, for the most part, it nearly always feels like they don’t communicate with each other at all.
It’s very frustrating.
While I have great difficulty using phones during the day due to the nature of my employment, several months ago I began balancing my attempts to contact by electronic messaging with contacting my physician’s office by phone. I began to notice over time that even utilizing this more direct method of contact seemed to be met by more layers akin to trying to call Comcast and having to go through four layers of hell before you reach a human being who has a clue.
Again, it’s very frustrating because in those times when someone has the insight to speak to my physician’s nurse or even my physician it seems as if whatever need has arisen is addressed in a timely and effective manner. Otherwise, it was nearly always a case of structure before service.
Then, “it” happened. It’s the latest craze in Indianapolis and maybe nationwide – “same day” appointments.
Ugh. I hate it.
My physician, who already doesn’t have any hours outside of my work hours, suddenly was becoming even less available because of some idiotic and misguided mandate that the network would offer “same day” appointments for primary care, a service that seems to be occurring in most of Central Indiana’s major networks. If it works in the other networks like it does with Community, I’m surprised that there hasn’t been a mass exodus.
I have been trying for no less than three months to schedule an appointment with my physician, including three times when I have contacted by phone. I have contacted multiple times by message through the Community Network and, in almost all cases, have inquired about specific days, times, or blocks of time. In nearly every case when using messaging, I’ve gotten an e-mail back saying “She doesn’t have anything available then. I’ve set you up for this time.”
“Um, that’s not what I asked for. I can’t make it then.” So, we’ll end up going back and forth multiple times and, on almost every occasion, I’ll propose alternatives and will get back another scheduled appointment.
It’s maddening. Yes, I’ve used that word twice in one post.
After finally catching on that either the scheduling was going through an outside office or there was simply no communication going on, I finally resorted to actually calling.
The first time? Okay, only a couple days’ notice.
The second time? Two weeks’ notice.
The third time? One week’s notice. This most recent time when I inquired about a specific day where I knew that I would be off work and available the entire day, I was informed “She’s entirely booked except for “same day” appointments.” But, now here’s the catch, they couldn’t go ahead and schedule “same day” because, well, it wasn’t the same day.
So, an established patient with known chronic health issues has to wait because your system prefers to service individuals with faux acuity who, in actuality, simply haven’t planned their lives very well? When I mentioned a couple of my issues, one of which I knew would qualify as acute, I was informed I could be seen for the “acute” issues but the preventative ones would need a different appointment.
I’m sorry Community, but that’s just plain fucking stupid.
If you are more attached to the rules of your structure than actually serving your patients, then you don’t deserve to call yourself a healthcare network because, quite simply, you don’t really care. It is 100% unacceptable that I was put off in this situation. I realize that my physician has become more established and is scheduled out farther than in the early days, but please don’t pretend that you are providing “convenient access” when in truth it appears that only your convenience matters.
Here’s where you have a chance to truly put the “care” back in healthcare and to truly prove yourselves to be a network that cares about the individuals you serve more than the structure that you’ve built.
Make it happen. Yep, that’s right. It’s that simple. I realize that there will always be exceptions to the ability to “make it happen,” but under no circumstances should it take multiple months for an established patient with known serious health issues to make an appointment with a physician when you’re sitting around spouting about “same day” appointments. There are those of us who live in the real world and can’t just drop everything “same day” because it fits better with your screwed up system. There are those of us who can’t just leave work whenever we want because we have obligations and commitments and because we take our jobs seriously. So, when we call you a few days or a week or two weeks in advance and give you an entire day when we really need to get in then it’s up to you, if you’re a responsible provider, to actually make it happen.
It’s truly that simple. “Same Day” is meaningless marketing crap and destined to fail. You want to prove that you’re a system that truly meets an individual’s needs? Listen to the individual and adapt your system to the needs of the individual.
That’s healthcare and that’s service.
Otherwise, you might as well give up your non-profit status because you clearly care more about the almighty dollar than you do the people you serve who, by the way, are the source of those almighty dollars.
I have to be honest and say that I’ve been looking around at other networks and other providers. I’ve been looking around, but the truth is I don’t want to look around. I like my physician. She’s taken the time to get to know me and, maybe even more importantly, I believe she actually cares.
But, the simple truth is that as an adult with serious health issues I need for those who are providing my healthcare to truly be accessible when it comes to meeting my needs. What’s it going to take? Does your computer system need to better identify your most vulnerable clients? Do you need to tweak the way your network communicates? Do I need to do something or say something differently?
Now is the time for you to live into that very first core value that you list on your website – “Patients first.” I need for you to live into that value with everything you have. I need for you to make sure that this “structure” you’ve built and designed to improve the patient experience doesn’t dominate the patient experience. I need for you, more than anything, to make sure that you’re putting the care into healthcare.