When the System Works

I have long been a critic of our health care system. I remain a critic of the system itself, as I believe it serves neither patient nor provider well with all its rules, rates, eligibility, networks, access, coverage and too often poor quality and inadequate safety.  In this morass, however, are gems that shine when the system works.  The system worked for me when I had my stroke two years ago. It worked again when I had a recent health crisis.  Neither time could I speak for myself.  The first I had an ardent advocate. The second time it was doctors I did not know in a local hospital that happened to be under contract with my insurer. I was just an unknown patient who came through the Emergency Room.   And the system worked.

Because the hospital was under contract with my insurer, the doctors had access to my medical records indicating a series of urgent visits. When I met with them in the morning, they had a summary for me about what had happened, why I was having some of the symptoms and started a round of antibiotics to deal with an advanced infection.   I was dehydrated and confused.  They were compassionate, straight forward and thorough. They explained the tests and why. They explained why it was important that I stay.

That was the surprise.  I hear stories of people being discharged a day or two after heart surgery.  Short lengths of stay—and pushed out.  One friend in her mid-80s was discharged two days after a hip replacement until she quite insistently protested. This is what I was expecting—a quick in and out and you’re on your own.

That was not the case.  They met with me, were concerned about my infection and wanted to keep me until I was stable and that they were convinced I was healed and could manage by myself.  To my complete surprise I was even given the option of staying an extra day if I did not feel confident about returning home and managing by myself.  I was stunned.

This worked because they paid attention to me as a person, reviewed my records (which luckily they had), determined a pattern and a potential cause, acted on it, discussed it with me and then gave me a choice.  Yes, my care was covered by insurance. But coverage does not always dictate care, nor does it guarantee personal attention to a patient.

Naysayers could say my experience can easily be dismissed as an isolated case. Yet I am beginning to hear other stories about doctors who take the time to know the patient, meet with their family and the patient to review the surgery, possible outcomes, and what to expect in the recovery process.

In all these cases it took some time, but it enhanced the comfort and knowledge of the patient and the family.  Detractors may say they did this to avoid future re-admissions for which hospitals are fined. But the fact remains these physicians cared, their care and concern inspired my confidence for recovery because I knew they had my best interests at heart not just the financial bottom line of the institution.

So, for all those physicians who are just as locked in the rules and regulations of the system as too many patients are, there are those shining moments when the system works—and it works because of the people from the doctor to the nurse, nurse assistants and the quiet cleaning person who makes sure the room is clean and safe. And it works when we as patients treat them as people who have chosen a caring profession and taken vows to do no harm and to heal.

Kathleen O’Connor

August 23, 2016

About Kathleen

Kathleen O’Connor: 30+ year health care consumer advocate, non-profit executive and author. For more information about Kathleen, please see “About” on the main content bar above.

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One Response to When the System Works

  1. Mary Koch says:

    Thank you so much for this commentary. I am grateful that you experienced care from individuals who work within the “system,” which must be challenging for them, yet at the same time they were compassionate and wise. I hope you are fully recovered. Yes, the system is dysfunctional and motivations are too often dollar-based. But blessed are they who stubbornly do what they are called to do and provide the care every patient should expect. Mary

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