Many will argue that the most important aspect of medical care is the knowledge and training the physician possesses; however others believe that the patient’s perspective on the care being received is more important. With approximately 100,000 to 200,000 deaths occurring from medical errors each year, patients and their families take a significant risk in the health care system when they seek treatment from a hospital or doctor. Trust is a defining element in an interpersonal relationship, but it is particularly central to the patient-physician relationship. Without trust in the physician and other medical staff providing care, the patient may not be fully willing to participate and cooperate in the medical treatment they would need.
In the event of an adverse medical event, the patient is the best determinant as to whether or not such an event has occurred. The patient is the one being served by medical professionals, and is the one who can account for the amount of pain being felt, the symptoms they have experienced, or effects of the treatment they are currently receiving. All of this information, along with laboratory and radiology reports, is critical to the physician’s final diagnosis. However, many times the patient’s voice is absent in the discussions about how to improve health care. Sometimes patients are too ill or lack the resources to take an active role in improving their health care quality. Patients and families then rely on the information of the physicians and other medical staff to ensure that information is properly relayed.
Patients and their families deserve to have a central role in improving healthcare quality. Informing healthcare professionals of any adverse medical events or medical errors, the patient’s experiences can be used by doctors and hospitals to help inform their quality improvement efforts.
References:
Pearson, Steven D., and Raeke, Lisa H. (2000). Patients’ trust in physicians: Many theories, few measures, and little data. Society of General Internal Medicine. Boston, MA.
Tuesday, June 21, 2011
Tuesday, June 7, 2011
Improving Veterans' Access to Care
Access to healthcare has been identified as a critical issue by the medical community, as well as by those in the veteran's affairs deparement. Historically, VA patients were able to obtain the healthcare they needed within an appropriate time frame. New research provides us with an updated concept of access that places a greater focus on post-access outcomes such as patient satisfaction, symptom levels, and functioning.
Most commonly studied was the association between distance from a VA facility and healthcare use, primarily outpatient or mental health services used. Evidence showed that increased distance from a VA facility was associated with decreased healthcare use. For those living 60 miles or more away from a facility, there was little change in the data received.
David Goldstein investigates the dilemma veterans in rural areas are facing, such as Frank Munk who must drive nearly 300 miles to a Department of Veterans Affairs hospital. Instead, Munk pays $2,500 out of pocket on a private doctor. The VA won't pay for a veteran to see an out-of-network doctor if the same care is available within the system - even if it's more convenient. 41% of enrollees in the VA health system (that's about 3 million veterans) are living in rural areas, unable to get the care they qualify for.
An internal audit of the efforts to improve health care for rural veterans concluded that the VA "lacked reasonable assurance" that its use of $273 million actually "improved access and quality of care" for veterans. Due to a lack of project performance measures, the VA office was unable to tell how effective their projects actually were.
In an attempt to cut costs yet still provide care, the VA has been using telemedicine to reach out to veterans from all war eras. Telemedicine allows patient to be diagnosed and treated via electronic communication. Another way rural veterans are able to receive medical care is through a network of about 800 community-based outpatient clinics that provide basic medical care such as chechups, X-rays and prescriptions. Yet for those veterans who have chronic or severe medical problems, the options for care are few.
While there appears to be a general agreement that VA hospitals provide good medical care, the system has been under stress due to the wars in Iraq and Afghanistan. Few expected these wars would last so long, or that there would be such a flood of patients, with severe injuries. Rural America is home to more than a third of the Iraq and Afghanistan veterans who are enrolled in the VA. VA spokesman Josh Taylor says the department is committed to expanding access to rural veterans. While the physical signs of battle are most often quickly cared for, the psychological wounds will require years, or even a lifetime to heal.
It was the veteran's choice to step up and serve our country, and now it is the VA's responsibility to provide the care they deserve.
Goldstein, David. (2011, June 7). For veterans in rural areas, health care can be a battle. McClatchy Newspapers.
Most commonly studied was the association between distance from a VA facility and healthcare use, primarily outpatient or mental health services used. Evidence showed that increased distance from a VA facility was associated with decreased healthcare use. For those living 60 miles or more away from a facility, there was little change in the data received.
David Goldstein investigates the dilemma veterans in rural areas are facing, such as Frank Munk who must drive nearly 300 miles to a Department of Veterans Affairs hospital. Instead, Munk pays $2,500 out of pocket on a private doctor. The VA won't pay for a veteran to see an out-of-network doctor if the same care is available within the system - even if it's more convenient. 41% of enrollees in the VA health system (that's about 3 million veterans) are living in rural areas, unable to get the care they qualify for.
An internal audit of the efforts to improve health care for rural veterans concluded that the VA "lacked reasonable assurance" that its use of $273 million actually "improved access and quality of care" for veterans. Due to a lack of project performance measures, the VA office was unable to tell how effective their projects actually were.
In an attempt to cut costs yet still provide care, the VA has been using telemedicine to reach out to veterans from all war eras. Telemedicine allows patient to be diagnosed and treated via electronic communication. Another way rural veterans are able to receive medical care is through a network of about 800 community-based outpatient clinics that provide basic medical care such as chechups, X-rays and prescriptions. Yet for those veterans who have chronic or severe medical problems, the options for care are few.
While there appears to be a general agreement that VA hospitals provide good medical care, the system has been under stress due to the wars in Iraq and Afghanistan. Few expected these wars would last so long, or that there would be such a flood of patients, with severe injuries. Rural America is home to more than a third of the Iraq and Afghanistan veterans who are enrolled in the VA. VA spokesman Josh Taylor says the department is committed to expanding access to rural veterans. While the physical signs of battle are most often quickly cared for, the psychological wounds will require years, or even a lifetime to heal.
It was the veteran's choice to step up and serve our country, and now it is the VA's responsibility to provide the care they deserve.
Goldstein, David. (2011, June 7). For veterans in rural areas, health care can be a battle. McClatchy Newspapers.
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