Yesterday’s post mentioned that 2001-02 Schweitzer Fellow Skye Schulte is currently an Account Director for Feinstein Kean Healthcare.  She also served previously as the Director of the Lead Action Collaborative (an initiative of The Boston Foundation) focused on prevention of childhood lead poisoning and other environmental hazards. 

She has published more than 100 articles on health and wellness, nutrition, cancer prevention, global public health, health literacy, behavior change, and health communication. She weighs in with a second installment of thoughts on health care reform below.

From your personal experience, is there a certain specific anecdote that best illustrates what’s broken about our healthcare system?

I’d be shocked to meet someone who had NOT had an experience with our broken healthcare system. I’ll just illustrate with my latest personal experience and put the “challenge” in parentheses.

A little over a year ago, for example, my husband and I switched over to an HMO plan because the PPO was increasing to a level we couldn’t justify paying. (Rising costs) My search for a new primary care provider began with asking friends for recommendations. After finding that these doctors were either not a part of my HMO plan or were not taking new patients, I looks through the online directory and randomly selected a number of primary care providers.

After failing to find any useful “quality” information or reviews of these individual doctors online, I gave up and started making calls and by about the 7th office call, found a doctor who was taking new patients. (Lack of useful information online regarding quality) Unfortunately, the soonest appointment I could get was almost 8 months away. (Lack of primary care physicians) So, you can imagine how excited I was when I finally got in to see her and get my long overdue check-up.

For probably the 30th time in my life, I took the clipboard the receptionist handed me and filled out my medical history AGAIN and described why I was in the office that day. (Lack of universal and portable electronic medical record)

After a long wait, I was rushed into the exam room where a frazzled and distracted doctor soon started to rapid-fire a list of symptoms at me and ask about my history. (Reimbursement aligned with # of patients seen and procedures done, not quality or preventive care)

I could barely register the word and respond yes/no before the next one was upon me. (Did I mention that she was also doing the exam at the same time?) Before we could even get to my real concerns she had deemed that everything was fine and had flown out of the room—telling me over her shoulder to schedule a time for labs. 

I wish I was shocked at this treatment and the overall experience but this was not the first (and certainly won’t be the last) bad healthcare experience for me. From talking with family and friends, this scenario and these experiences are all too common and this is just unacceptable. I know that my friends and colleagues who work as healthcare providers don’t want these experiences to happen and fight against them wherever they can, but the current environment does not make this easy. 

Are you encouraged or discouraged by the current political conversations about health care reform? Why?

I am encouraged by any logical and constructive debate about healthcare reform.

I think the greatest asset our current healthcare system has are the dedicated and passionate healthcare providers, researchers, and others who hold a wealth of knowledge on what is “broken” in healthcare (both from experience and practice), as well as some best practices and model systems for making healthcare more affordable, timely, personalized, and efficient.

The tricky part is that you need the right culture, the right incentives, and the right resources and environment to achieve most of these innovations. Universal adoption and use of electronic medical records is no exception and I would welcome any conversations that try to get at addressing these issues. I also think it’s imperative that those who are a part of the current system are involved in the discussions and decisions of how to make things better. In the past, politicians have left important stakeholder groups out of these discussions, so I am encouraged to see that more of my colleagues are informed and engaged about the debate and are actively participating.  

What news sources do you follow to stay informed regarding discussions about healthcare reform? Do you feel that news coverage of these discussions is adequate, or are there perspectives out there that aren’t getting heard?

I learned early on in my studies that every news source has its own mediated reality of the world and what is happening. In order to get a more balanced view of things and hear multiple perspectives, I try to follow multiple resources and communications channels. For example, in addition to reading articles from CNN, the New York Times, and the Wall Street Journal, I might also look at expert blogs, government and other websites, and even listen to podcasts or radio shows on the issue. Healthcare reform has even popped up at recent conferences and meetings I’ve attended, so the key is to keep your ears open, listen, and ask good questions.