EMERGENCY ROOMS BECOMING URGENT CARE CENTERS

EMERGENCY ROOMS BECOMING URGENT CARE CENTERS

More patients are coming to the emergency room with minor symptoms.  They are called fast track patients, since they are quick cases that can command a several hundred-dollar facility fee, for treating a cold for instance.  This cost shifting is playing the filed that the government gave hospitals with its current rules.

Nurse practitioners and physician assistants are employed to expedite the fast track discharges. It adds to about $100 an hour for 16 hours each day.  The price tag goes up with resultant increased liability by the physician in charge whose name is at the bottom of many charts he has not even seen. 

ELECTRONIC RECORD SYSTEM

Since electronic information systems are in full force in hospitals, the residents and staff spend more time on their computers than talking to their patients.  Blood tests, and scanning tests are done before looking at the patients.  Such unnecessary testing raises the price tag on hospital visits in an attempt to increasing patient turnover time and faster discharges and reducing hospital stays.   This leads to faulty observations and diagnosis without talking to the patient and substantiating the tests with a good physical examination.

But are physical examinations becoming obsolete?  Is the time spent to learn the art of a comprehensive physical well spent compared to the accuracy, reliability of modern medical technology?  Malpractice fears of not being objective as tests are, and financial pressure to maximize doctor’s time is taking precedent over the traditional physical exam.  Certainly the number of expert physical examiners is dwindling.

Since most medical students are brought up on computers they are groomed on digital systems in academic centers.  They see local hospitals that don’t provide electronic records as lacking in safe patient care, inability to work efficiently, to share and communicate information, and want electronic record systems in the hospitals they select as interns and residents.

Obama wants to modernize our U.S. health care records system.  But are our electronic record systems able to talk to each other or will this fragmented systems make things worse than they are.  The current crop of electronic programs if implemented will stifle innovation that is needed to make the electronic record system useful.  It certainly will increase clinical and administrative errors with the medical user interface complexity.

Doctors are reluctant to adopt electronic records because most of the rewards go to the insurance companies instead of the doctors.   In the office, it will cost $50k per doctor, and this does not include the lost productivity as the staff learns the new technology.  The doctors will save 11% by using the system.   It is a high-risk venture that puts doctors income at peril. 

PROHIBITING PRIVATE HEALTH CARE

Health care reformists see a scenario, like Canada, to single tier health care.  How would you feel not being able to spend more money for a higher tier of care?  With a world of “health care prohibition”, cash only medical services would sprout catering to patients unable to tolerate the restrictions and waiting in a single payer system.  We are used to choice and having premium on demand health care. That will never change.  Prohibition did not work for alcohol, is not working in drug coverage, and certainly will not work for health care.

NATIONWIDE ELECTRONIC MEDICAL SYSTEM

Nationwide electronic medical-information system  is coming soon.   Changing the coding system that doctors and hospital use to bill insurers will undergo a complete overhaul within the next  three years.  It will be the next step in a nationwide electronic medical-information system.

There will be more billing errors, you the patient will be overcharged, the insurance company will be able to deny your doctor’s claim stating it didn’t have the proper code.  There will be more billing fraud and you and the doctors will not be paid quickly.  You will need to give the doctor more medical details, and each insurance company will want different details of your life.

                  Source: WSj nov 11,2008

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