Is it getting harder to coordinate our care?
How does more consolidation affect care management?
Maybe it’s just me, but it seems that coordinating my healthcare is getting harder. It’s important for those of us with chronic obstructive pulmonary disease (COPD) to coordinate medications and other treatments so that we get optimum results.
When I was diagnosed with COPD, all but one of my physicians operated as an independent business. Today the tides have turned, and all but one of my doctors belong to a healthcare or hospital system. While consolidation may be financially prudent and offer stability to physicians, I think it can interrupt the continuity of care.
Although it may seem counterintuitive, this consolidation leads to higher healthcare costs. If something costs more, we expect it to perform better than something that’s less expensive. In a 2014 study, the Commonwealth Fund found that this isn’t the case for the U.S. healthcare system.
Some of the reasons doctors decide to do this, as my pulmonologist noted, include lower malpractice insurance costs and assistance with office management and billing. When his office manager died from COVID-19, he said he couldn’t find a suitable replacement.
The most recent of my physicians who left independent business was my general practitioner. I got a call from a doctor whose name I didn’t recognize informing me that I had an appointment scheduled. I didn’t know how to reschedule the appointment or notify them that I couldn’t attend. I knew the appointment was with my general practitioner because the time and date were listed on an appointment card.
A friend of mine who lives in a rural area told me that this consolidation has actually improved his coordination of care. He now has to deal with only one hospital system. In my case, I’m dealing with four. My diagnostician and pulmonologist are in the Athenahealth system, while my cardiologist is still independent, and this trio works well together.
This system has made it easier to collaborate with the physicians involved, schedule appointments, pay bills, and ask questions. I credit the quick turnaround in getting my care scheduled when I thought I had lung cancer to my ability to ask questions and receive answers from my providers.
My general practitioner now is with AccessHealth, or at least I received a letter to that effect last month. I was told that I would still see my doctor at his office, but I don’t know how to contact him except through one of the doctors listed on the website.
This may well be an excellent system, but right now I feel like I’m in a river without a raft and quickly approaching the rapids.
These are some of the pros and cons that I’ve noticed regarding the consolidation of care into larger healthcare and hospital systems. What experience have you had? Please share in the comments below.
Note: COPD News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of COPD News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to chronic obstructive pulmonary disease.
About the Author
Harvey Sanders
I don't really understand the issue. I try to keep my providers to be at the same Medical company with a like patient portal so they can share information. My primary care and my cardio doctors are both with the save hospital while my pulmonologist is independent with a different patient portal. It's difficult for all 3 to be aware of what's happening.
Monroe (Tim) Williams
I have been in the Evergreen Hosp. "system" for the last 15 yrs. and I believe it makes everything easier for me. Example, was when my Cardiologist put me on water elimination pills, it went in my chart, and my pulmo. Dr. and Family Dr. and my INR clinic that checks my blood monthy, as I take "warfarin" were automatically alerted to that, It was in "my chart" immediately, as it is all one system. I can e mail any of them, and receive an e mail back within 24 hours. I can view my lab results, my next appointment, make a new appointment, etc. The sharing of information between your personl Dr. and (in some cases) the many other specialists, just makes good practical sense, and this is the best way to make sure that happens.
Pam Marshall
My experience has been different. I have Kaiser Permanente, and it is much easier to coordinate my care, most of the time all in one place. Even if I have go through an outside doctor, my care information is available through Kaiser in most cases, so everyone is on the same page. That is important for people with COPD, but also for anyone dealing with a chronic illness. I have had doctors change, but I have been notified of the change and there are usually multiple doctors to choose from. But I will say that once I have a team that I am comfortable with, I don't feel good about that changing. It is important to be comfortable with your providers as well as to be proactive in your care.
Gerald Burgess
I would 3to know more
JAMES YOCKEY
Now there are independent people with medical backgrounds beginning their own service to coordinate medical services, records and efficiency between all doctors/specialists who are being paid by Medicare and/or advantage plans. I have one I am waiting on to be accepted by Humana here in Florida. Needed Badly!