Letters

Physician ACOs? Makes Sense

Re: "Physicians Are Building Their Own ACOs" by Ken Terry, November H&HN

It makes sense that physician groups are going after ACOs, with gainsharing an upside opportunity. It is possible to try out incented coordinated care with a group of colleagues/partners to confirm viability. Patients linked to doctors linked to each other and with real-time notification of high-risk, high-dollar (admits, key referrals, meds, imaging, etc.) events seem to be the ingredients. Another one we're seeing is the desire/need for proprietary analysis of shared information — allowing both cooperation and competition to flourish in the same market.

— John Haughton

Expand Medicare to All

Re: "Exchanges Help Lead a Wave of Consumerism in the Insurance Arena" by Marty Stempniak in H&HN Daily, Dec. 6

The insurance exchanges will just add more complexity to our health care market. They will not reduce costs except by forcing the public to seek more "affordable" policies that will put more burden on the patients and their families once they face an illness. We are the only developed country in the world that still uses the for-profit insurance industry to finance health care.

What we need is a national health program — improved and expanded Medicare for all — to cover everyone in America and to control long-term costs. Our present supply-driven market is not sustainable, and what we see now with the exchanges is the death spiral of a bad market system.

— Art Sutherland, M.D.
Tennessee coordinator
Physicians for National Health Program

The Patient Isn't Always Right

Re: "Providers, Payers: Are They Really All That Different Nowadays? by Marty Stempniak in H&HN Daily, Dec. 4

I hear you, but would like to challenge the assumption that this is all to the good (and I'm not a physician or other provider with turf to defend). Example: Blood pressure. There can be a huge difference between blood pressure readings taken too quickly after a patient arrives and one taken after the patient has cooled his heels long enough for his blood pressure to normalize. This can mean the difference between being prescribed a blood pressure medication you don't truly need and avoiding that undesirable outcome.

In other words, indulging patients' impatience may mean compromising on the quality of their health care. Because unlike retail, the patient isn't always right. We therefore need to be careful to not throw the baby out with the bathwater in an attempt to commercialize or commoditize our health care.

Sometimes that little wait in the waiting room may actually be serving a constructive purpose, though it surely needs to be better managed and made even more constructive (e.g., by having patients use the time to prioritize their questions, list their medications/supplements, etc.).

— John Lynch

The Consumer Is Missing

Re: "Consumer Relations 101" by Mary Grayson in H&HN Daily, Dec. 10

Enjoyed your podcast and couldn't agree more — the consumer is being left behind in discussions about how health care reform will impact them.

Health care marketers in particular should be taking advantage of this period to educate, inform and help their target audiences. Not doing so is a missed opportunity.

— Daniel Fell

Epidemic of Empathy

Re: "The Role of Empathy in Cost Reduction" by Curt Bailey and Traci Entil in H&HN Daily, Nov. 28

Top-down empathy is both highly effective and highly infective. An institutional epidemic creates a true "culture of caring" — a state that is often touted and seldom achieved.

— Tom Scaletta

This is such an important message. There is no stronger buy-in than when staff are engaged in creating solutions. Employees often tell me in focus groups that they are struggling to do more with less and that they don't feel like their voices are heard during heavy-handed cuts. The result is exactly as you describe: disengaged staff delivering marginal service. By creating capacity for continuous improvement, you help eliminate the "scarcity" mentality that frequently pits one department against another while everyone rushes to protect their turf.

— Kristin Baird