2 minute read
A Crisis in Healthcare Access
(Part 2 of a 3-part series)
In Part 1 of this post, I described a fundamental problem we have in accessing quality healthcare: finding the right doctor.
Why is this happening? Let’s start by defining the “right doctor”. The process of accessing healthcare, specifically, the right doctor for a specific condition, is in the stone ages. Physicians are grouped into broad specialties, but tend to have a fairly narrow sub-specialization or “sweet spot” where their experience, training and passion coincide – this is when the “right” doctor is treating a patient.
Because of the ever-expanding nature of medical science, specialists are specializing more than ever! New treatments, minimally-invasive procedures, medications, etc., demand a tremendous amount of expertise that requires time, focus and interest on behalf of the physician to develop that sweet spot. When specialists are referred patients, they don’t necessarily turn them away or re-refer them if the patient’s condition is not in their sweet spot. It’s simply not the practice. We believe that they shouldn’t have to be put in that situation in the first place.
If consumers are matched to the correct provider who has the training, experience and proven outcomes to treat their condition, along with access to the right facilities and care teams, magic happens. All of the amazing resources we have at our disposal align to provide a superior experience and outcomes for the lowest total cost of care.
This sounds and is fundamental. However, this seldom happens.
In most cases, the referral or recommendation for a doctor is under- or ill-informed. It is not based on the condition of the patient. The complex task of matching their condition to the skills, strengths and experience of the provider is currently haphazard at best. The referral is limited by “who the referring source knows”, “who the referral source had a good experience with – possibly for another unrelated condition”, motivation based on a financial relationship (rewards), or physician advertising.
Consumers are incredibly frustrated by the process of accessing healthcare and are seeking any means necessary to find doctors, including social media or blindly scrolling through practically useless provider directories on their insurance or local health system websites. Without a process and supporting technologies that understand the needs of the consumer and can match consumers’ conditions and preferences to the strengths and appropriateness of the provider, this negative cycle of unacceptable outcomes, spending and experience will continue.
This problem has been around for a long time - so long that the elephant in the room is now largely invisible. People, in general, are unaware that there is a better way because they can’t conceive a better way. They simply tolerate the lack of precision in finding a doctor and have grown accustomed to long wait times and uninformed choices.
READ MORE: Part 3 of this series - The Solution
What You Can Do About The Access Problem Now
For more information, download our whitepaper The Specialty Care Referral Dilemma: The Desperate Need for Clinical Navigation to Improve Value-Based Healthcare authored by our Clinical Advisory Board Executive Committee members.
Interested in objective, quality doctor recommendations for yourself and/or your family? Enroll now in QualityCare Connect and get peace of mind.
ArmadaHealth has no legal or financial relationship with the physicians we recommend.