Reform Proposal #1

As we have learned in class, cost, quality, and access are three important aspects of healthcare to consider when making any changes (Jecklin). The changes our group wants to propose relate to our main values and beliefs. Our main values are a concern for the underprivileged in society, nationwide access to healthcare, and equally good services in poor/rural communities compared to affluent/urban areas. Our main beliefs are the importance of technology in healthcare, the necessary role of social and spiritual elements of health, and the use of clinical interventions instead of alternative therapies.

By having the government/private providers increase the number of outpatient facilities, this will provide better access for elderly and other underprivileged patients as they may not be able to travel far to receive medical care. Also, by healthcare providers spending more time on patient (and family) education, this should increase the number of patients who understand what is expected of them for following medication directions and comprehending the details of their medical care, resulting in better quality care.

Some may argue that nationwide access to quality healthcare through a government universal healthcare system will increase costs initially, but it would result in better access, which our group values. Better access would result in better quality care over a person’s lifetime and increase the likelihood that they would see the same primary physician consistently. Dr. Bruce Auerbach of the Massachusetts Medical Society explained, when patients have “a relationship with” a primary care physician, “those individuals…have the best outcomes” (Bowler). According the Shi & Singh, “A health services delivery system that lacks universal access is ill-equipped” to provide continuity of care.

In order to overcome racial/ethnic and geographic barriers and increase access and quality while maintaining affordable, the government/private providers must concentrate on the placement of and access to outpatient clinics. We also need to pay attention to the costs and affordability of the healthcare and not let them increase too much.

Initially, incorporating the use of better technology in outpatient services may result in higher costs, but it will improve the quality of care. Also, increases in technology allow for the formation of more outpatient clinics and also procedures to be performed at lower costs in less time, increasing the quality. This in turn leads to greater availability and access because more patients can be treated in one facility in the same amount of time (Emory Healthcare).

Dr. Thomas Hines of Boston University Medical Center states, “The most essential skill for a good family doctor is knowing what [the patient] know[s], knowing what [the patient] do[es]n't know, and being able to distinguish the difference between those two things” (Bowser). As important as noting that difference is educating the patient on what they need to do. Being aware of each individual’s needs based on their condition, age, culture will improve the quality of healthcare (Adler). Different patients need different levels of social/spiritual involvement and healthcare providers must be aware of this and act appropriately.

Studies have proven the use of clinical interventions in the treatment of patients as being beneficial. To greater promote this, healthcare institutions should place an emphasis on reaching the populations around them and informing them of the benefits of healthcare. Also, caution must be exercised to maintain respect for others and their beliefs. However, they should be informed of the healthcare options that are available.

Improving outpatient and primary care is of great importance because our healthcare system is continually shifting from hospitals and inpatient services to outpatient and primary care services. Insurance companies have also begun to prefer outpatient services more than inpatient services (Shi and Singh). Our society will probably continue the trend of increasing demand for outpatient and primary care services. “Industrialized countries with strong primary care networks -- the Netherlands, Germany, Switzerland -- have some of the world's best medical outcomes: longer life expectancy and lower infant mortality rates” (Bowler).

By Sabrina Klein

References:

Adler, A. M., & Carlton, R. R. (2007). Introduction to radiologic sciences and patient
care. St. Louis, Missouri: Saunders Elsevier.

Bowler, B. A. (2009). States face shortages of primary care doctors. PBS News. Retrieved February 27, 2009, from: http://www.pbs.org/newshour/bb/health/jan-june09/doctors_01-06.html.

Emory Healthcare.(n.d.) Improvement report: Outpatient-centered care: Quality, access, efficiency, and patient satisfaction. Retrieved February 27, 2009, from: http://www.ihi.org/IHI/Topics/OfficePractices/ Access/ImprovementStories/ OutpatientCenteredCareQualityAccess EfficiencySatisfaction.htm.

Jecklin, R. (2009). Cost, access, and quality [PowerPoint slides]. Retrieved February 18, 2009, from: https://uwlax.courses.wisconsin.edu/d2l/orgTools/ouHome/ouHome.asp.

Shi, L., & Singh, D. A. (2008). Delivering health care in America: a systems approach. Sudbury,
Massachusetts: Jones and Bartlett.