Higher Quality Medical Care Comes With Relationship, Not Data Compilation
Humans are complex creatures, designed for interaction and the use of ideas and reason to prompt their actions. A well-established relationship between individuals is essential in the process of communication, which is the basic foundation in any successful interaction. Therefore, establishing a relationship is important to quality medical care.
What is it you look for in a physician? Want do you want from your physician? What kind of return on investment do you seek? What sort of value does having a personal physician have for you?
Ask anyone who is 55 years or greater if they had a physician when growing up. Unless they lived in a fairly remote area, chances are they will tell you a story of their family “doc,” who “caught” them when they were born, saw them through the childhood diseases and accidents, counseled them as they prepared for college, did their exam and blood work for their marriage. They will likely remember them with a far-off look in their eye, re-experiencing fondly the antiseptic smell of the office, the creak of the wooden chairs in the waiting room, and the confidence they had that their physician knew all about them. Ask them, after they tell the story, if they feel they had a higher quality of care than they do today. Ask them to compare and contrast the difference of that relationship with the one they have with their present-day physician(s).
How do their stories compare to YOUR story? Did you have a family physician growing up? Do you have a primary care physician today? Do you feel there has been a shift of paradigm away from the traditional practice of medicine to an impersonal “healthcare facility?” Unarguably, technology in medicine has greatly increased in recent years, but have human beings changed much as well? Why has there been such an effort to sterilize the relationship between patients and physicians? Why have so many barriers been placed between them? Has it been more of a side effect of technology, or has it been purposeful?
Let me ask you more: do you have an attorney? Have you ever needed an attorney, but not had one “on retainer” or in your speed dial? Have you ever found yourself in a situation where you suddenly, urgently, needed an attorney? Wouldn’t it have been far better to have established a relationship with an attorney well before you needed one emergently? A family attorney would be nice, one who had represented your family for years, who watched you grow up and knew everything about you so that when the need arose you would have someone to turn to. You would know you had someone “in your corner,” an advocate in court. You would also know that anything you revealed to your attorney is confidential. There are few barriers in the client-attorney relationship.
Why should your relationship with your primary care physician be any less crucial than that with your attorney? Are the experiences of your mind and body any less sacred than your legal concerns? Shouldn’t what you discuss with your physician be as confidential as what you discuss with your attorney? Are attorney fees less expensive than physician fees? Why is there no subsidized exchange to purchase legal insurance?
All these questions are aimed to spark the fire of enquiry. Think of it this way: you have been programmed to believe that you must have health insurance, and that you must have a physician who bills your insurance, and that that insurance company has the right to all your medical records because, after all, they are paying the bills. And of course, there has to be insurance oversight, and hospital oversight, and clinic oversight, and physician oversight, because the government is only here to take care of you, to watch over you, to make sure you aren’t harmed in any way by any of these parties. And the result of all this oversight is the achievement of the highest quality of care anyone could have! Or is it? If you KNOW that the insurance company has access to your records, are you more likely to confide your tobacco use or your recreational drug use or your sexual preference or whether you use “protection” to your physician? What difference does it make to the physician? No sense revealing that little problem you had one time with high blood pressure that the insurance company may use to drop you, or increase your rates. If you have nothing to hide, then why do you care who reads your chart? But, what if you don’t know whether you have nothing to hide or not? What if there is mining of your records for data of which you are not even aware could be considered suspicious? Are you “non-compliant?” What does that even MEAN?? Can one have a higher quality of care when there are those kinds of barriers in communication and relationship? Or do you expect quality of care to be higher in a situation of a better, closer relationship?
Good relationships encourage openness and frankness, which helps the physician greatly to better diagnose. Better diagnoses leads to better treatment plans and better treatment plans lead to higher quality of care. Physicians who focus on the individual in front of them as opposed to what the insurance company – or the employer, or the Department of Health & Human Services via their “interoperable health information infrastructure” wants documented – will provide better care.
Seek that kind of relationship, seek that kind of primary care physician, and don’t wait until it has become urgent. Keep that physician and their cell phone on speed dial, keep them on retainer, so when the time comes that is of the essence you don’t find yourself wondering what to do.
And you, the patient, will be happier, and – possibly, hopefully – healthier.