Doctors and patients agree that more change is needed

The experience of caring for a loved one such as a parent or grandparent is something that many people share.  Depending on the situation this can be an especially difficult time and unfortunately, navigating the health care system can be a big contributor to this.

What might be surprising to some is that many providers such as physicians and nurses acknowledge this as well.  They know that for all of their efforts, the way that our health care system works makes it hard to achieve the results they want while keeping the patient and their family involved.  Below is a comment from Dr. Christine Arenson that I think accurately illustrates some of the shared frustrations of those that know the health care system best:

“As a practicing family physician and geriatrician, I work daily with patients from across the economic spectrum, for whom the best, evidence-based self-management and chronic care support simply DOES NOT exist.  This is the case even for those who are not relying exclusively on public programs and are able to pay for these services themselves.   I also see the waste and unaligned incentives which so often lead to poor care and bad outcomes.

Furthermore, as a physician educator working with my team to teach and implement some of the proven strategies around improving geriatric care, I face the up-hill battle of convincing my students that there is a better way to practice and to impact the lives of their patients. Too often, they see our work as unrealistic and impossible in the “real world” of health care as it is currently practiced in America.

In order for my profession to provide more coordinated, patient-centered care, the incentives in our system need to be such that they actually support the use of evidence-based treatment.  This is in contrast to our current system that simply encourages providers to order more procedures and prescribe more medications. We must be able to engage patients in self-management support, education, and behavior change strategies with proven efficacy, and we need greater ability to test and disseminate practice-based interdisciplinary team-care to learn how to realize the true potential of the patient-centered medical home.”

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