Monday, June 22, 2009

Pondering NPR While Commuting from the Woods

An odd schedule this week; I am seeing patients while camping near that beautiful view you all saw in yesterday's post. My first 3 patients did not come in for their appointments, and I have time for a quick blog entry on one of the stroies that I heard on NPR which cruising (at the speed limit) down the Massachusetts turnpike morning.

You can hear the story here, I will sumarize it for you. Patients, particularly complex elderly patients, are finding that they need an advocate within the system, who understands their needs and desires and understands the multifaceted health care system well enough to guide you through the system. They highlighted two models- one was volunteer retired physicians and nurses who work with hospitalized patient and are able to ask the questions in such a way that the system would respond. The other was what I would call "concierge nurses" who coordinate care for folks in assisted living, helping to keep them out of the hospital. The story ends by pointing out that noone wants to pay to support these services, and suggested that we need data to justify this fairly self-evident cost to the system.

Both of these groups of people do what your primary care physician no longer has time to do; know you so that you can be known. The similarities to the impending ICC program seemed to suggest a similar trap lay ahead for us. As we roll out the CSAs, we need to be sure to collect the data to justify this cost, as we certainly believe that it is part of the cost of doing business.

Patients are here- got to go.

(And I just added a picture of the swollen stream near our campsite. )

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