Have you ever walked into a doctor’s office, urgent care center, or some other “healthcare” environment and felt like you were nothing more than a drain on the staff’s time? Have you ever been asked if you had insurance and watched the polite smile melt away as you answered “no” to the question? How about trying to schedule an appointment, something that should be a quick simple task ends up making you feel like you’re a huge bother. These questions frame scenarios that play-out across the nation every day and with increasing frequency. This is the very profession where such attitudes should be the last thing one expects, but all too often have to face. Why is that?
Today’s healthcare is not the healthcare we often see portrayed on TV. There was only one “reality show” that revealed the actual scene that takes place in emergency situations, with doctor error, poor communication, and near chaos. In contrast, television shows have heroic doctors performing at a frenetic pace without hesitation and with unrivaled confidence. It’s no wonder that medical “reality show” did not make it past the first season. The reality was just too embarrassing.
The model of healthcare we have today does not work! Looking around the world at other systems of care leaves the United States quickly earning itself a very low state of respect. Some say it’s because the U.S. has such a large population compared to other industrialized nations, but proportionally speaking, this argument is a fallacy.
Per capita healthcare spending in the U.S. is higher than anywhere else in the world, and is nearly twice that of thirteen comparable Organizations for Economic Cooperation and Development (OECD) countries. Is it the old argument that U.S. population numbers are shifting toward those aged 65 or older, and therefore costs are rising for long-term, chronic, and end-of-life care? Not really; eleven of the thirteen OECD countries compared had higher percentages of the elderly in their populations and spent far less of their Gross Domestic Product (GDP) on healthcare.
How about smoking? Nope; of the thirteen countries under consideration, only Sweden had a lower percentage of smokers than the United States. The one area where the U.S. far outweighs the other countries is the percentage of population classified as obese. A huge third of the population waddled into this category back in 2009.
In most cases, unless you have an appointment with the specialist and I can bet on several occasions that you’ve sat for an extended period of time waiting to see your doctor. Why is this? It’s due to the over-booking of patients. Let’s say for example, a doctor see’s four patients at fifteen minute intervals per hour. If the doctor’s schedule is booked at 2:00, 2:15, 2:30, 2:45, and then a fifth patient is added within that hour, so this means that your doctor needs an hour and fifteen minutes to see those five patients. Every patient from that point on will have to wait. I worked for a doctor’s office foe twelve years that doubled booked at least two patients almost every hour of the doctors schedule, which would put the doctor behind at least a half an hour. One would think that the main reason for all of this double scheduling was the patients, no; it was because the doctor’s didn’t want to lose out on the money. To make matters worse, some doctors would end up so far behind; patients would be waiting for two-three hours to see their doctor (I’m dead serious). I don’t know about you, but for me that’s pretty sad and pathetic.
Here’s another situation where money comes before the patient. You go in for a simple nurse visit to get your blood draw at your doctor’s office. You’re called in for your appointment and find that you are asked to get your weight and blood pressure. Hmm, wait; weren’t you just there to get your blood drawn? Could it be that your doctor is just looking out for you? Probably not, some doctors’ offices want staff to get a recorded weight and blood pressure, so they can charge you a complete office visit. Now that’s just sneaky!
So, what does any of this have to do with the attitude eluded-to above? A further examination of the numbers reveals that the United States has higher rates of pay than most anywhere else; sometimes 2 or 3 times higher. Nurses with an average of experience across the board make more than the national median income and far more than comparable nations worldwide but most quit from burnout after a few short years stating that the nature of the work is nasty, overwhelming in terms of nurse to patient ratios, and potentially dangerous.
However, it is no less (and in fact probably more) nasty, overwhelming, and dangerous in other locations around the world where nurses make far less money and work more hours.
This remains a contentious issue. One argument states that U.S. healthcare should not compare itself to other less developed countries where healthcare standards are not held to the same high expectations. The other argument holds that U.S. nursing is elitist, spoiled, and carries an attitude of entitlement. So which is true?
The reality is that there is some of either argument to be seen in U.S. healthcare from coast to coast. To blanket-classify nursing, or any other care service vector, is a mistake. There are obviously those who are wholly committed to their profession, and those who merely make an appearance for a paycheck. Next question: What is the answer?
It is simple really. Follow the example of California nurses and demand regulation of the profession with patient safety as a first concern. When nurses, and any other segment of healthcare personnel, can effectively and efficiently manage their workload, the quality of care increases and so do positive outcomes. What a simple concept huh? Well what about that attitude?
That attitude comes from human beings who are asked to perform at levels, and in life or death situations, found in very, very few other professions in the world.
The system as a whole needs to be overhauled from the ground up, and not merely patched with third party payer “versions” of healthcare, like the Affordable Care Act. Everything from the cost of a medical education and final training for physicians, to the costs of time for every activity performed on the floor (and the resources needed for such) needs to be studied and quantified according to real-world costs for those resources. Once this is done, a much more realistic, effective, and efficient model for utilizing human talent (and all other resources) will emerge. Until then, just get used to the attitude.
Can you relate to this article? Have you had to deal with attitudes in healthcare?