I’ll be the first to say that our medical system, despite its flaws, is miraculous.
The care that healthcare providers give on a day-to-day basis, in terms of complexity and art and compassion is astounding, especially when we look at how far we’ve come in the last 100 years.
That said, the evidence is mounting that in many ways, the negative effects of contact with the healthcare system are significant. Are they usually are out weighed by the benefits of accessing healthcare? Certainly. But just as every drug has its side effects, the side effects of medical visits and hospital stays themselves are becoming more obvious and quantified.So does healthcare really have a negative impact on health?
I think there is strong evidence that it does. For instance, this article on “post hospital syndrome” raises the point that hospital stays can be extremely damaging to the overall health of patients, especially the elderly. While the stays tend to treat the original illness, there is observed to be a significant impact on the patient's overall health, wellness, and independence.
In fact, post-hospital syndrome seems to be a cause of the very high readmission rates among older people. In 2016, about 18 percent of discharged Medicare beneficiaries returned to the hospital within 30 days, according to the federal Centers for Medicare and Medicaid Services.
Dr. Harlan Krumholz, a cardiologist at Yale University, has been looking at the reasons for this. When he looked at 30-day readmissions, he found that many causes of readmissions had nothing to do with the initial admission. “Patients came in with heart failure or pneumonia, were treated and discharged, then returned with internal bleeding or injuries from a fall. ‘Our general approach in a hospital is, all hands on deck to deal with the problem people come in with,’ Dr. Krumholz said. ‘All the other discomforts are seen as a minor inconvenience.’”
But the other discomforts can be incredibly serious when it comes to health and recovery after an illness. Dr. Krumholz is finding that simple things that keep patients’ lives as normal as possible even when hospitalized can have a big impact — walks down the corridor, wearing their clothes, eating normal foods, etc. These things can make it so that muscle loss, cognitive degradation, confusion, balance issues, and the like are all mitigated.
Solutions are mimicking regular life. But the only thing better than that is actual regular life -- keeping people out of the hospital, or even away from a doctor's office, as much as possible.
Similarly, outside of an inpatient context, we tend to refer and set appointments as if the transportation isn’t a relevant concern. But as this article explores, healthcare transportation can be a major impediment to care, a huge expense, and a important disruption to the patient’s life.
Each contact with the medical system comes at a cost. These costs can come in the form of money, transportation, and a negative impact on the things that keep people healthy and happy. And so many times, our patients don't need to be interacting with the healthcare system nearly as much as they do. A referral to a second provider, with its accompanying visit (and long drive, and a day off work or play), could easily be replaced by a quick consult with a tool like iClickCare. A hospital visit may be able to be shortened by 30% if the providers on the case had a quick way to touch base on the patient's status. Hopping between doctors for different diagnosis perspectives can be replaced by team-based medical collaboration (like hybrid store-and-forward® telemedicine.)
So what are providers to do? My opinion is that when healthcare providers work together more, patients need to interact with the healthcare system less. The truth is that when we are able to collaborate effectively, we dramatically cut down on length of stay, total number of medical visits, and time spent in a medical setting.
Evidence shows that home, and regular life, is where people heal. So let’s work together so our patients can spend more time there -- and less time in a hospital bed or in a doctor's office.
iClickCare is a simple way to cut length of stay and even visits. You can try it for free here: