Anthem Healthcare had a survey conducted of over 1,000 senior citizens older than 65 years of age in the hospital between September 26 and October 13, 2016. This Harris Poll found that 85% of the participants had a real medical issue. The poll also indicated:
Sixty-four (64%) percent said they had at least three different health care providers (at one time these were called doctors.)
- Sixty-nine (69%) percent rely on a family member or themselves to organize and coordinate their care.
- Sixty-four percent (64%) of those recently hospitalized said no one helped coordinate their care after their hospital discharge for months at a time.
- Less than half of those surveyed (<50%) said that they were asked about medications or treatments provided by other physicians that might impact their current care. With no one checking drugs and drug interactions this raises major safety issues.
The findings are not surprising to me and reinforce why I limited my practice size and leave sufficient time to learn about who else is caring for my patients and what, and why, they are recommending their specific care plan. It requires reviewing medication lists painstakingly including accessing pharmaceutical data bases and asking patients and their caregivers to bring all their medications and supplements to the office in their original pill bottles. For instance, you can’t tell how much potentially dangerous fat soluble vitamins your patients are ingesting without reading the labels. You need to run the drug-drug interaction software to insure that medicine combinations are not making your patient ill
It’s important to know who else is providing care to this patient and why. As their primary care physician, you need to ask patients to request old medical records and request a consult summary from their other doctors. You then need to invest the time necessary to review these documents. It’s a two-way street; providing your patients’ other physicians with your office notes as well as lab and test results. Sometimes a phone call to another doctor is necessary to clarify treatment recommendations and to then assist and educate your patient concerning the reasoning and goals of the treatments.
Often, family conferences in person or by phone are needed to inform caring relatives about what support and assistance the patient requires and how they can be of help. It takes time listening to your patients’ concerns, advocating on their behalf and preventing well-meaning treatment from others from causing harm because they are unaware of the patient’s medication or problem list.
In today’s world, concierge and direct pay primary care practices are providing these services while polls sponsored by mega-health entities confirm those organizations are falling far short in doing so!