Providers can be defined as everyone working within the healthcare system. They are all of those who, in some fashion, are in the business or profession of providing care to a patient. Providers include state and county government, insurance companies, pharmaceutical companies, clinics, medical care management companies (such as PeaceHealth in Washington) and a host of other businesses. The point is they are businesses first and their primary outlook is a corporate one aimed at profit or, if non-profit, cost management. Corporate thinking, profits, and cost controls dominate our healthcare system, and this puts the patient far down the list of priorities and makes him or her an object to be managed for the provider’s benefit. Corporations unfortunately care for patients using the same methods and practices as AT&T, Comcast or General Motors. Does thinking about your cable, cell phone or auto dealer inspire you to want the same management for healthcare service? Government cares for patients along the same lines as TSA (Transportation Security Administration) and IRS (Internal Revenue Service) do their jobs. Does that sound desirable?
Providers — all providers — are one of the audiences I have in mind for this blog. Others are caregivers and patients. Arguably, patient Shearlean Duke was well cared for and had a successful outcome, given her terminal condition. While Shearlean was not physically injured by the system, she (the patient) and I (the caregiver) were wronged by the healthcare system by all the hardship, stress, complexity, threat, fear, manipulation, and unnecessary demands placed on us by the “system.” We could have done without all of that and had a much better experience even if the outcome were the same.
The hands-on providers — the doctors, nurses, technicians, and clinical staff — are at the mercy of the system they are in. Government and corporate forces overwhelm these providers to almost the same degree they overwhelm patients.
Consequently, it is only when I talk with hands-on providers about my experience that I successfully communicate the problems patients and caregivers are having with the healthcare system. The majority of other providers haven’t a clue about what I am talking about. The corporate and government providers are obsessed with business as usual, profit and cost containment, in which the patient and pesky caregiver are troublesome elements to be managed until they can be made to go away by discharge, cure, transfer or burial. This makes them deaf to patient needs and concerns.
By painstakingly documenting the defects and problems I encounter in the healthcare system, and defining them in terms of their impact on patient and caregiver, I hope to give all providers understandable examples of what is wrong with the system and their role in it. The adverse effect of the healthcare system on patient and caregiver is not that of a tsunami but rather of erosion — slow, irresistible and subtle, but something able to carve a Grand Canyon.
Because this blog is not a blog on management, profit, sales, marketing or business it is likely to be shunned by most healthcare providers. That will be a shame because it will delay much needed reform that the providers themselves will one day wish had been implemented before it was their turn as patient or caregiver.