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	<title>Payers - Medika Life</title>
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		<title>Beyond Data: Why Human Decisions Are Shaped by Facts, Feelings—and the Fire Within</title>
		<link>https://medika.life/beyond-data-why-human-decisions-are-shaped-by-facts-feelings-and-the-fire-within/</link>
		
		<dc:creator><![CDATA[Gil Bashe, Medika Life Editor]]></dc:creator>
		<pubDate>Wed, 21 May 2025 18:57:45 +0000</pubDate>
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		<guid isPermaLink="false">https://medika.life/?p=21129</guid>

					<description><![CDATA[<p>“Branding is a matter of building trust and committing to a level of quality and service. It is an emotional connection that transcends the actual product.” —Gil Bashe, &#8220;Global Marketing Strategies&#8221; and &#8220;Emotion: The New Brand Integrator,&#8221; Pharmaceutical Executive, 2000 Twenty-five years ago, in a series of articles for Pharmaceutical Executive that may have seemed [&#8230;]</p>
<p>The post <a href="https://medika.life/beyond-data-why-human-decisions-are-shaped-by-facts-feelings-and-the-fire-within/">Beyond Data: Why Human Decisions Are Shaped by Facts, Feelings—and the Fire Within</a> appeared first on <a href="https://medika.life">Medika Life</a>.</p>
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<p>“Branding is a matter of building trust and committing to a level of quality and service. It is an emotional connection that transcends the actual product.”</p>



<p>—Gil Bashe, &#8220;Global Marketing Strategies&#8221; and &#8220;Emotion: The New Brand Integrator,&#8221; <a href="https://www.pharmexec.com/authors/gil-bashe">Pharmaceutical Executive</a>, 2000</p>



<p>Twenty-five years ago, in a series of articles for Pharmaceutical Executive that may have seemed radical at the time, I argued that successful marketing wasn’t built on features but feelings. Back then, people were skeptical. “Emotion?” they responded. “We’re here to sell solutions.” Yet, as I revisit that article from the perspective of today’s fractured health landscape, I realize just how prescient that core message was.</p>



<p>In 2000, I wrote, “A brand must reflect the soul of the company. It must reflect its leadership and people&#8217;s beliefs, philosophies, and practices.” That truth remains, but in today’s health sector—beset by cost crises, consumer distrust, and system complexity—the soul of the brand must go even deeper. It must speak to human experience. It must unite the head (facts), heart (feelings), and gut (intuition) to unite the five pillars of the care community: patients, payers, product innovators, policymakers and providers.</p>



<p>The brands that do this don’t just survive, they lead.</p>



<h2 class="wp-block-heading"><strong>The Head: Anchor in Truth, Lead with Clarity</strong></h2>



<p>We live in an era of data deluge. The health industry is drowning in numbers, from EMR systems to clinical trial dashboards. Yet many brands still mistake data for direction.</p>



<p>Yes, the head—facts—matter. Health is a science of logic, science, and proof. But it is also an art.</p>



<p>In my original article, I noted that the “hallmark of a strong brand is clarity—a clear promise, consistently delivered.” In health, clarity is more than a brand virtue; it’s a money and mission obligation. Patients need clarity in order to make life-altering choices. Providers need clarity in order to correctly apply new technologies and administer novel treatments. Payers need clarity so that they may judge value and outcomes.</p>



<p>A brand that leads with the head communicates what it does and why it matters. The science, the evidence, the safety profile: these aspects of health products are essential. But they are not enough.</p>



<p>I wrote in 2000, “Even the most successful product will not remain so without continuous reaffirmation of its value and identity.” It’s still true today, but that reaffirmation must be human, not simply clinical.</p>



<h2 class="wp-block-heading"><strong>The Heart: Where Value Becomes Meaning</strong></h2>



<p>A quarter-century ago, I argued that “emotional connection” was key to global brand success. In 2024, I echoed that idea, stating that empathy is a strategic imperative, not a “soft skill.” Writing in Medika Life, I asserted that “Empathy—the ability to sense and connect to another’s experience—has clinical consequences.”</p>



<p>Health isn’t delivered in abstracts. It’s experienced in human moments: a nurse’s tone of voice, the wait time for an appointment, a doctor’s bedside manner. Patients remember how they felt, not what was said.</p>



<p>The same is true of brand impressions. A health brand’s heart is measured by its humanity: how it listens, responds, and affirms the lived experience. Consider the rise of narrative medicine, patient-centered care design, or trauma-informed policy. These are not trends. They are a return to what medicine truly is: a human endeavor.</p>



<p>In 2000, I wrote that “People buy brands because they trust them and because those brands represent a relationship.” It’s never been more true. That relationship must be emotional. If we don’t move hearts, we will never move health.</p>



<h2 class="wp-block-heading"><strong>The Gut: The Compass for Courage and Change</strong></h2>



<p>If the head is what we know, and the heart is what we feel, then the gut is what we sense. It’s instinct informed by experience. It’s the courage to take a stand when the data is inconclusive. It’s also the discipline to say no when a decision doesn’t align with the brand&#8217;s soul.</p>



<p>In 2000, I observed that “Global brands are built not just on strategy, but on intuition—on understanding the culture and values of the people they serve.” That same intuition now guides how we engage health audiences. Do we sense distrust? Fear? Exhaustion? Our gut tells us when a message is too technical, dense or transactional to resonate. It urges us to simplify and re-center on the human.</p>



<p>Great leaders trust their gut because it helps them detect the intangibles: tone, timing and truth. In brand leadership, that same sense keeps us authentic.</p>



<h2 class="wp-block-heading"><strong>Reuniting the Quintet: Patients, Payers, Product Innovators, Policymakers and Providers</strong></h2>



<p>Today’s health ecosystem is fractured along functional lines. Patients seek access, providers seek time, and payers seek value. Too often, they work in silos, leaving innovation and empathy at the margins.</p>



<p>But brands can be bridges. When built with head, heart, and gut, they become platforms for unity.</p>



<p>I wrote in 2000 that the “challenge is to ensure that everyone in the organization consistently communicates the brand through behavior, not just brochures.” That principle is now essential in aligning care delivery. Health brands must operate across disciplines, sectors, and even continents, but always with a singular message: we see, hear, and serve you.</p>



<p>Whether you’re a Medicaid insurer, a diagnostics company, or a telehealth platform, your brand is a promise. And that promise must connect the person in the exam room with the person writing the policy.</p>



<h2 class="wp-block-heading"><strong>The ROI of Human Experience</strong></h2>



<p>In 2025, health leaders face dual pressures: cut costs and elevate care. This seems like a paradox, but it’s not. Investing in human experience is not a detour from efficiency; it’s the gateway to it.</p>



<p>Empathy reduces readmissions, clear communication improves medication adherence, and trusted brands drive engagement. When we center on people, we improve systems.</p>



<p>Put simply, mission and money must align. One cannot exist without the other in sustainable health ecosystems.</p>



<h2 class="wp-block-heading"><strong>Final Thought: A New Brand Equation</strong></h2>



<p>As I wrote in Global Marketing Strategies 25 years ago, “A brand is the product of what people feel, not just what they see.” That message, once contrarian, is now the compass.</p>



<p>The future of health brands is in the hands of those willing to embrace complexity with clarity, wield emotion with discipline, and make instinct an asset, not a liability. In short, the best brands will speak to the head with intelligence, the heart with empathy, and the gut with courage.</p>



<p>In an age when trust is currency and gaining attention means cutting through the information jungle, this is not just good branding. It’s savvy mission-centered business leadership.</p>
<p>The post <a href="https://medika.life/beyond-data-why-human-decisions-are-shaped-by-facts-feelings-and-the-fire-within/">Beyond Data: Why Human Decisions Are Shaped by Facts, Feelings—and the Fire Within</a> appeared first on <a href="https://medika.life">Medika Life</a>.</p>
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		<post-id xmlns="com-wordpress:feed-additions:1">21129</post-id>	</item>
		<item>
		<title>Hospital Managers, Medical Decisions, and Patients’ Need to Know</title>
		<link>https://medika.life/hospital-managers-medical-decisions-and-patients-need-to-know/</link>
		
		<dc:creator><![CDATA[Pat Farrell PhD]]></dc:creator>
		<pubDate>Tue, 09 Jul 2024 11:26:26 +0000</pubDate>
				<category><![CDATA[Editors Choice]]></category>
		<category><![CDATA[Ethics in Practice]]></category>
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		<category><![CDATA[Patricia Farrell]]></category>
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		<guid isPermaLink="false">https://medika.life/?p=19966</guid>

					<description><![CDATA[<p>Medical decisions are being made not only by insurance companies but also by hospital managers and algorithms, and concern for patient care continues to grow.</p>
<p>The post <a href="https://medika.life/hospital-managers-medical-decisions-and-patients-need-to-know/">Hospital Managers, Medical Decisions, and Patients’ Need to Know</a> appeared first on <a href="https://medika.life">Medika Life</a>.</p>
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<p id="5db3">The term “corporatization” in healthcare is still being debated, but most people agree that it means that&nbsp;<em>healthcare organizations are being taken over by a large corporation</em>&nbsp;that rule over or replaces local autonomy. It can also mean that hospitals and health systems are changing their behavior to&nbsp;<em>prioritize making money over caring for patients</em>.</p>



<p id="d692">I’ve had a physician tell me, in strictest confidence, that the hospital replaces physicians who leave with any available MD, regardless of their expertise. “<em>They see an MD as an MD, and that’s it</em>.” We have to wonder what effect this has on patient care.</p>



<p id="8018">In an&nbsp;<a href="https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2024/march-2024-volume-109-issue-3/surgeons-are-prioritizing-patients-amid-the-corporatization-of-healthcare/" rel="noreferrer noopener" target="_blank">ideal practice setting, medicine and surgery</a>&nbsp;are used in a two-way connection between a doctor and a patient, with support from leadership, staff, and the care team. The clinician has all the tools they need to heal. The goal should be to do what is best for the patient at all times.</p>



<p id="6583">But there is ample proof that the health system is becoming increasingly corporate. In&nbsp;<strong>2023, 65 hospitals or health systems</strong>&nbsp;revealed deals to merge or buy other hospitals,&nbsp;<strong>bringing in more than $38 billion</strong>. The business of medicine is a big part of the economy, especially since the&nbsp;<em>US spends almost $5 trillion a year on healthcare</em>. And the&nbsp;<a href="https://www.pgpf.org/blog/2023/07/why-the-american-healthcare-system-underperforms#:~:text=Total%20healthcare%20costs%20%E2%80%94%20including%20all" rel="noreferrer noopener" target="_blank">system is underperforming</a>.</p>



<p id="c13d">Private equity investors have a big stake in the US healthcare system; they&nbsp;<strong>own more than 30% of hospitals</strong>&nbsp;in some markets and almost 400 hospitals. Little is left for the smaller hospitals or, indeed, the single practitioner who wishes to work independently. Little by little, they are being forced into a market that seems to smack of monopolistic practices.</p>



<p id="00e0">In&nbsp;<a href="https://www.nytimes.com/2023/06/15/magazine/doctors-moral-crises.html" rel="noreferrer noopener" target="_blank">America’s profit-driven healthcare system</a>, physicians believe they are hurt when managers, hospital executives, and insurers make them&nbsp;<em>break the rules of ethics</em>&nbsp;that were supposed to guide their profession. It is hard for many physicians to balance their Hippocratic oath with the reality of&nbsp;<em>making money off of sick and vulnerable people.&nbsp;</em>Some say this promotes a very high rate of&nbsp;<a href="https://osteopathic.org/2024/02/29/nearly-half-of-physicians-surveyed-say-theyre-burned-out-in-2024/#:~:text=Nearly%20half%20of%20physicians%20report,53%25%20of%20physicians%20reported%20burnout." rel="noreferrer noopener" target="_blank">physician suicide and burnout</a>.</p>



<p id="f452">The 2024 physician burnout and depression study from&nbsp;<a href="https://www.medscape.com/slideshow/2024-lifestyle-burnout-6016865" rel="noreferrer noopener" target="_blank"><strong>Medscape</strong></a>&nbsp;says that almost&nbsp;<em>half of physicians feel burned out. The number of physicians who are burned out has gone down since last year, when 53%</em>&nbsp;said they were burned out. But many are considering leaving the field. Due to employees quitting,&nbsp;<em>the resource gap in available care will widen</em>. Nurses, too, are leaving the field because of overload, lack of support, and wages.</p>



<p id="d77d">A physician I spoke to told me that he&nbsp;<em>resisted being bought by a hospital chain</em>&nbsp;and, as a result,&nbsp;<em>will not be permitted to admit patients</em>&nbsp;there or&nbsp;<em>receive referrals</em>; they are squeezing him out of existence. He now plans to leave medicine in about two years. The daily stress of dealing with insurance companies is exhausting for his staff.</p>



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<p id="1c67">The concerns regarding patient care are real, and the US government realizes them. The Office of Civil Rights in the U.S. Department of Health and Human Services released a rule about the nondiscrimination section in&nbsp;<a href="https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/ama-fact-sheet-section-1557.pdf" rel="noreferrer noopener" target="_blank">Section 1557 of the Affordable Care Act</a>&nbsp;(PDF). This rule could punish doctors if they&nbsp;<em>use algorithm-based tools</em>&nbsp;that cause discriminatory harm.</p>



<p id="137c">The Federation of State Medical Boards also put out a set of rules saying that&nbsp;<em>doctors are responsible for harm</em>&nbsp;caused by tools that use algorithms.&nbsp;<strong>But what if the physicians or staff have little say</strong>&nbsp;over how algorithms are used and who uses them? Can we hold them responsible for management’s actions? And, if management is a private equity company, where does the buck stop?&nbsp;<a href="https://www.trumanlibrary.gov/education/trivia/buck-stops-here-sign" rel="noreferrer noopener" target="_blank"><strong>Harry Truman knew</strong></a>.</p>



<p id="c817">A new&nbsp;<a href="https://insights.sca.health/insight/article/benefits-and-risks-of-ai" rel="noreferrer noopener" target="_blank">report from the World Health Organization</a>&nbsp;(WHO) discusses five fundamental ways AI LLMs could be used in medicine and public health:&nbsp;<em>diagnosis, patient care, administrative chores, medical education, and research</em>. However, the study also&nbsp;<strong>warns that AI comes with big risks of bias, unfairness, privacy breaches, and problems with openness</strong>.</p>



<p id="fdce">Experts and civil society groups share these worries. Depending on algorithms that are&nbsp;<em>devoid of emotion and only deal with data&nbsp;</em>is taking a road too far and giving too much power to a math formula over medical staff and patient input. In fact,&nbsp;<em>there is NO patient input, only data</em>.</p>



<p id="3e85">One patient I knew who found a major error in the EHR attempted to have it remediated to the correct information—it took seven years, and the patient was told&nbsp;<em>the hospital could do nothing about the EPIC software</em>&nbsp;<em>errors</em>. How is it possible that a program has no fail-safe corrections for inaccurate diagnoses, treatments, or medications and on which major health decisions are made?</p>



<p id="b962">One thing about making&nbsp;<a href="https://www.forbes.com/sites/lanceeliot/2024/01/28/can-generative-ai-convince-medical-doctors-they-are-wrong-when-they-are-right-and-right-when-they-are-wrong/" rel="noreferrer noopener" target="_blank">professional decisions is that the situation is often much tougher&nbsp;</a>and more complicated than people think. The assumption is that it is not hard to make a medically complicated decision. You need to gather a few facts and think about them like a medical professional (i.e., a doctor), and you can figure out exactly what the patient is sick with and how to treat it. That’s how AI would act, and it would be done within minutes if not seconds.</p>



<p id="a5cf">But medical staff need to&nbsp;<em>consider more variables than the AI may have been trained on</em>&nbsp;and therein may lie a bed of thorns. Who is truly conversant with the limits of AI training and the&nbsp;<em>bias inherent within its vast network</em>? Certainly, hospital staff aren’t equipped to do much. What are the potential harmful effects?</p>



<p id="4886">The AI tools and&nbsp;<a href="https://www.nature.com/articles/s41746-024-01093-w" rel="noreferrer noopener" target="_blank">machine learning (ML) methods that make them up are not perfect,&nbsp;</a>and it is not likely that they will ever be. So, adding AI will bring benefits and the common problem of&nbsp;<a href="https://link.springer.com/article/10.1007/s10278-022-00731-7" rel="noreferrer noopener" target="_blank">AI tools making mistakes</a>. According to a study from the&nbsp;<a href="https://www.europarl.europa.eu/RegData/etudes/STUD/2022/729512/EPRS_STU(2022)729512_EN.pdf" rel="noreferrer noopener" target="_blank">European Parliamentary Research Service,&nbsp;</a>one of the biggest risks of putting AI into healthcare is that&nbsp;<em>it could hurt patients through mistakes.</em></p>



<p id="c3cf">Are hospital administrators or private equity managers up to the task of monitoring instead of zeroing in on the bottom-line savings of AI? Instead of becoming a major moneymaker for them, it could become a swamp of lawsuits that will push some of them into bankruptcy from major decisions against them.</p>



<p id="a112">Caution seems to have been thrown to the wind in the heady giddiness that may be exhibited by people who should know better. Yes, I realize I am being caustic, but people&#8217;s lives, livelihoods, and professions are on the line. W<em>e are not talking about trading stocks but working with lives.</em></p>
<p>The post <a href="https://medika.life/hospital-managers-medical-decisions-and-patients-need-to-know/">Hospital Managers, Medical Decisions, and Patients’ Need to Know</a> appeared first on <a href="https://medika.life">Medika Life</a>.</p>
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		<post-id xmlns="com-wordpress:feed-additions:1">19966</post-id>	</item>
		<item>
		<title>Unearth Your Medical Records And Be Prepared For Surprises</title>
		<link>https://medika.life/unearth-your-medical-records-and-be-prepared-for-surprises/</link>
		
		<dc:creator><![CDATA[Pat Farrell PhD]]></dc:creator>
		<pubDate>Wed, 21 Sep 2022 01:10:32 +0000</pubDate>
				<category><![CDATA[Digital Health]]></category>
		<category><![CDATA[Diseases]]></category>
		<category><![CDATA[Editors Choice]]></category>
		<category><![CDATA[For Doctors]]></category>
		<category><![CDATA[General Health]]></category>
		<category><![CDATA[Healthcare Policy and Opinion]]></category>
		<category><![CDATA[Public Health]]></category>
		<category><![CDATA[EMR]]></category>
		<category><![CDATA[Medical Records]]></category>
		<category><![CDATA[Patient Engagement]]></category>
		<category><![CDATA[Patient History]]></category>
		<category><![CDATA[Patricia Farrell]]></category>
		<category><![CDATA[Payers]]></category>
		<category><![CDATA[providers]]></category>
		<guid isPermaLink="false">https://medika.life/?p=16282</guid>

					<description><![CDATA[<p>How much do you know about what’s in all those medical records and databases about you? Shouldn’t you have a copy for review and safekeeping?</p>
<p>The post <a href="https://medika.life/unearth-your-medical-records-and-be-prepared-for-surprises/">Unearth Your Medical Records And Be Prepared For Surprises</a> appeared first on <a href="https://medika.life">Medika Life</a>.</p>
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<p id="f6ec"><a href="https://www.healthit.gov/faq/what-electronic-health-record-ehr" rel="noreferrer noopener" target="_blank">Electronic health records&nbsp;</a>(EHR) have taken over the daunting task of maintaining the medical information of millions of patients. In the interest of providing medical care that is well integrated, databases of these records are shared among hospitals and healthcare facilities.</p>



<p id="92b6">But what if&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797550/" rel="noreferrer noopener" target="_blank">an error is made</a>&nbsp;and propagated to the records in other facilities and keeps propagating again and again and again? The error becomes harder to untangle from the original database and all the others that quickly incorporated it in the interests of medical care.</p>



<p id="ec87">Consider how one drop-down menu mistake for a patient’s medication might&nbsp;<a href="https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.01423" rel="noreferrer noopener" target="_blank">introduce bias in treatment</a>&nbsp;into the record. But who would know it was a mistake if the patient never saw their record and felt there was no reason to ask for a copy?</p>



<p id="dec8">The&nbsp;<a href="https://www.healthit.gov/sites/default/files/pdf/privacy/privacy-and-security-guide-chapter-3.pdf" rel="noreferrer noopener" target="_blank">law is on the patient’s side</a>, but facilities may not always be so willing to release the records. There is&nbsp;<a href="https://www.apaservices.org/practice/business/hipaa/information-blocking-rule-faq" rel="noreferrer noopener" target="_blank">an exception</a>&nbsp;where the facility could argue that the information would somehow harm the patient. Harmful to know what’s in your record? Are we children? How and when can a patient be refused access?</p>



<p id="5f35"><a href="https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html#:~:text=With%20limited%20exceptions%2C%20the%20HIPAA,care%20providers%20and%20health%20plans." rel="noreferrer noopener" target="_blank"><em>With limited exceptions</em></a><em>, the HIPAA Privacy Rule (the Privacy Rule) provides individuals with a legal, enforceable right to see and receive copies upon request of the information in their medical and other health records maintained by their health care providers and health plans.</em></p>



<p id="4882">If you want more information on HIPAA regulations and your rights, there is&nbsp;<a href="https://www.hhs.gov/sites/default/files/righttoaccessmemo.pdf" rel="noreferrer noopener" target="_blank">material</a>, and you can also&nbsp;<a href="https://www.hhs.gov/hipaa/filing-a-complaint/index.html" rel="noreferrer noopener" target="_blank">file a complaint online</a>.</p>



<p id="16b3">How might inaccurate information be placed in your EHR? Many medications have similar names, and there may be two names for the same drug (brand name and generic). If personnel are unfamiliar with all the names and select the wrong one from the computer drop-down menu, your record has that error in it. But would that be a significant problem for you? I think it might.</p>



<p id="32f7">Medications for psychiatric disorders, if entered into your record as a prior medication or one to which you had an&nbsp;<a href="https://mcathub.com/aes-medical-abbreviation/" rel="noreferrer noopener" target="_blank">AE</a>&nbsp;(adverse event/allergy), staff reviewing your record will see it. Healthcare personnel is as fallible and biased as anyone else, and they may make certain assumptions about your mental state.</p>



<p id="e4b5">Any other medications that may have been entered incorrectly could also affect the treatments or drugs used in someone’s care. In any case, errors must be corrected, and the facilities that house them in their databases are required to make the adjustments.</p>



<p id="ad45"><em>Should everyone request a complete copy of their medical records?</em>&nbsp;It’s a personal choice, but keeping your records ensures that you know what is in them, and you can have peace of mind knowing there are no untoward errors about which you were unaware.</p>



<p id="269a">Previously, requesting these records meant paying at least $1/page in some states, but today the entire thing can be burned onto a CD/DVD or put on a thumb drive. It’s not cumbersome and can easily be scanned for material information you want to select within the file. Remember that “pdf” documents have that “find” feature.</p>



<p id="e7b1">Obtaining medical records for yourself, a child, or a family member requires that you know the procedures.&nbsp;<a href="https://www.healthit.gov/how-to-get-your-health-record/get-it/" rel="noreferrer noopener" target="_blank">Here is a website</a>&nbsp;that provides much of this information.</p>



<p id="d7c8">Have you looked at your medical records lately?</p>
<p>The post <a href="https://medika.life/unearth-your-medical-records-and-be-prepared-for-surprises/">Unearth Your Medical Records And Be Prepared For Surprises</a> appeared first on <a href="https://medika.life">Medika Life</a>.</p>
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		<post-id xmlns="com-wordpress:feed-additions:1">16282</post-id>	</item>
		<item>
		<title>Consumerism in Healthcare</title>
		<link>https://medika.life/consumerism-in-healthcare/</link>
		
		<dc:creator><![CDATA[Stephen Schimpff, MD MACP]]></dc:creator>
		<pubDate>Tue, 02 Aug 2022 20:35:39 +0000</pubDate>
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					<description><![CDATA[<p>A new and developing force in medicine will add a new set of dramatic changes: the force of consumerism. No longer will you, as a patient, be willing to be “patient.” </p>
<p>The post <a href="https://medika.life/consumerism-in-healthcare/">Consumerism in Healthcare</a> appeared first on <a href="https://medika.life">Medika Life</a>.</p>
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<p id="7fca">A new and developing force in medicine will add a new set of dramatic changes: the force of consumerism. No longer will you, as a patient, be willing to be “patient.” Instead, you will expect your caregiver to be responsive, prompt, effective, efficient, and — notably- polite and professional. Not dissimilar to what you expect and usually get from your other “vendors” like lawyers, accountants, plumbers, whoever. With these people, you change to someone else if you are displeased. </p>



<p id="7fca">Until now, you just sort of accept medical caregivers to be what it is, even if it frustrates you. But the time is rapidly approaching when you will expect an adequate period of time with your caregiver, that the caregiver will know you as a person and indeed know you as a person that is part of a family, a community, and a society. You will not tolerate any longer being treated as a “number,” a “case,” or as a “problem.” If you don’t receive the care as described, you will seek out care elsewhere.</p>



<p id="6970">An example of this is a friend, Rebecca, a physician’s wife, who developed breast cancer. She was seen immediately by a topnotch surgeon who did her biopsy and then lumpectomy in a very timely manner with plenty of discussion and “hand holding,” She then went to a highly regarded medical oncologist with the expectation that she would receive her drug therapy and radiation therapy at that individual’s hospital. She knew that the oncologist was well trained and very competent. However, the physician seemed pleasant enough but not engaging and not really focused on my friend as a person. </p>



<p id="6970">It seemed as though she went through a “checklist” of information in a “rote-like” manner. Rebecca felt like she was just “one more” breast cancer patient rather than an individual with a particular problem. She felt that perhaps the physician was just having a tough day or that she, the patient, was being seen at the end of a long line of other patients that day. But no matter, this was the physician who was to be her primary caregiver concerning an issue of utmost importance to her. The result: My friend went elsewhere for her medical oncology and radiation therapy care. The basic message, of course, is that patients now want and expect not only competency but also personal and professional care and will both pay for it and demand it. A bit of empathy doesn’t hurt either.</p>



<p id="3dd6">Compare that story to this one. A couple, Bob and Ruth, went to a small Caribbean island for a two-week vacation. On the last day of their vacation, the husband had a heart attack. Bob was taken to the island’s small 25-bed hospital. He and Ruth, who works at a major hospital in a patient care/advocacy profession, were immediately concerned that the level of care would not be up to the standards that they would have expected in their large U.S. city. However, what they found, to their obvious pleasure, was a highly skilled physician who was also highly interactive with the two of them. He did the appropriate diagnostic tests to demonstrate that it was a heart attack and then began the proper medical therapy. Concurrently he arranged for Bob’s air transport to a major Florida hospital.</p>



<p id="107d">Meanwhile, others at this small hospital helped Ruth cope with her concerns and deal with some practical issues of getting checked out of the hotel, returning the rental car, arranging medical evacuation flight and all the other details that needed to be done. In short, they looked after her as well as her husband. Ruth cannot speak highly enough of the care that her husband received.</p>



<p id="37cf">Both of these patients were “connected” to the healthcare professions. So, if you think compassionate, attentive care always comes to such individuals, think again. Years ago, doctors offered their colleagues and families “professional courtesy.” No more. That will not change, but whether the doctor or family member is a patient or not, they will expect compassionate, attentive care just like everyone else. They may be the ones to push the system the hardest and, at the same time, “look in the mirror” at their own practice patterns and initiate change. Change will occur but never as soon as desired.</p>



<p id="e453">Both of these stories also illustrate the issue of complex, chronic disease. These diseases do not go away; they can often be cured, but the possibility of a subsequent problem [heart failure] or recurrence [cancer] is real. Many chronic illnesses will be with the patient for life. They require many different practitioners with differing skills to help care for them, which all need coordination. </p>



<p id="e453">But in America today, care for these complex, chronic illnesses, which consume more than 70% of all medical care expenditures, are definitely not addressed in a coordinated manner except in a few centers and practices. This means that the care is not up to the quality levels it could be given our knowledge base and our excellent practitioners, and it also means that the costs are much too high. We need to find a way to change our delivery system so that it delivers coordinated, compassionate, and safe care to individuals with these complex, chronic diseases.</p>



<p id="c9e3">Here is a “problem” which everyone needs to understand. If you are on Medicare, Medicare sets the payment for the doctor. He or she cannot bill you more than what Medicare allows. So, if you say to your doctor, “Look, I’d like to spend some more time to fully have you understand my situation or so that I can better understand your advice,” the doctor can say “OK” but Medicare will not pay any more for that extra time and the physician, by law, cannot bill you for the extra time spent. If you were doing a new will and wanted to spend more time understanding what the lawyer was recommending, the lawyer would say “OK,” but both of you would know that you would be billed for the added time. With Medicare, you don’t have that option.</p>



<p id="0d73">Consider Renee. A few years ago, she asked me for the name of a physician who would give her the time needed for her situation as an older single lady with multiple chronic problems not being fully addressed by her all too many doctors. I suggested Gary Milles, MD MPH, who has a “concierge” practice. He charges a flat fee of $1850 per year and, in return, is available by cell phone 24/7, text, and email. He has only about 490 patients, unlike his original practice with 2700. So, he can offer same or next-day appointments lasting as long as needed. </p>



<p id="0d73">Each year he does a very comprehensive evaluation lasting two hours, including multiple blood tests, a vision, hearing, and pulmonary analysis at no added charge. Importantly, if a specialist is needed, he will call that doctor directly, explain why he is referring you, and ask for a prompt appointment. That means you will be seen much sooner than if you called that doctor’s office and the doctor will understand why you are there when you come for your appointment. This all makes a big difference in care.</p>



<p id="3a40">“You aced it when you referred me to Dr. Gary Milles! He has been terrific for me. First, he found out why I’ve had very high BP for four years, e.g., 250/160. Then, instead of all those blood pressure pills, he stopped them and put me on something less powerful and with less side effects and stopped some supplements recommended by a different doctor, adjusted my diet, and gave me some suggestions on stress management. As a result, blood pressure is now OK. So far, so good….we had to make only one adjustment after several months!</p>



<p id="eb7f">“But now I need to see a pulmonologist. The one he recommended did not work out. Great background and experience, but when I had my first visit, things started out poorly (very impatient and rude with me) and quickly spiraled downhill. He definitely is not for me. I will ask for another option.” Dr Milles was thankful that she reported the poor caring and sent her to another pulmonologist who had the appropriate medical but also personal skills. The first pulmonologist will not be getting referrals in the future.</p>



<figure class="wp-block-image size-full"><img fetchpriority="high" decoding="async" width="538" height="762" src="https://i0.wp.com/medika.life/wp-content/uploads/2022/08/image.png?resize=538%2C762&#038;ssl=1" alt="" class="wp-image-16010" srcset="https://i0.wp.com/medika.life/wp-content/uploads/2022/08/image.png?w=538&amp;ssl=1 538w, https://i0.wp.com/medika.life/wp-content/uploads/2022/08/image.png?resize=212%2C300&amp;ssl=1 212w, https://i0.wp.com/medika.life/wp-content/uploads/2022/08/image.png?resize=150%2C212&amp;ssl=1 150w, https://i0.wp.com/medika.life/wp-content/uploads/2022/08/image.png?resize=300%2C425&amp;ssl=1 300w" sizes="(max-width: 538px) 100vw, 538px" data-recalc-dims="1" /><figcaption>Direct Primary Care/Concierge Models Offer Major Advantages — Author’s Image</figcaption></figure>



<p id="d699">This change to “patient first” is occurring slowly, beginning with primary care physicians, using the direct primary care or concierge models, regaining the time needed to give adequate, expert attention, and, when necessary, coordinating multiple specialists. This means much better quality of care, coordination when needed, all tied into genuine compassion and caring. In that way, it will be a return to my physician grandfather’s time when treatment options were limited. Empathy and caring will be uppermost while still preserving the incredible advances modern science has brought forth. It will mean better care, less patient frustration, less doctor frustration and burnout, and a huge reduction in total costs as an added, very important bonus.</p>



<p id="8c64">It is a contract between the doctor and patient; no insurer is involved. But of course, if the patient does not feel well treated, the contract is voided, and they will move on to someone else.</p>
<p>The post <a href="https://medika.life/consumerism-in-healthcare/">Consumerism in Healthcare</a> appeared first on <a href="https://medika.life">Medika Life</a>.</p>
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