What to say about the popular press accounts (such as this one, in the 9/7/10 New York Times) of a new study of acute care treatment published in the current issue of Health Affairs (Stephen R. Pitts, et al, Where Americans Get Acute Care: Increasingly, It’s Not At Their Doctor’s Office. Health Affairs, September 2010) ?
The options are numerous:
- Primary care is broken, and the study simply quantifies what has been known for years;
- Primary care is broken, and the study highlights looming challenges for the implementation of effective health system reform in accord with new Federal legislation;
- Primary care is broken, and the study provides a needed platform for outlining effective primary care delivery alternatives
You may discern a theme here, dear reader… 
The difficulty is that appropriate conclusions are not self-evident. Is educating ER users about more-appropriate treatment venues the best fix? Perhaps hospitals could solve the problem with relatively simple adjustments to their EMTALA obligations? Surely the nation’s policies regarding EMR/PHR adoption can play a positive role in channeling individuals to the most appropriate care settings for their health conditions? And of course we can’t forget the possibility that a combination of these and other approaches might yield valuable improvements….
Our initial feeling is that close examination of decisions about where to obtain acute care treatment would be well worth the time and trouble. People get care where they get care for reasons, and we imagine those reasons are at once practical, malleable. and deeply affected by both ingrained habits and available information about alternatives.
When we undertake to make people’s care-consumption decisions better for them and for our health care system, we’lll do better by looking at what people actually do rather than go by practitioner beliefs/desires regarding what people should do.
25
Aug 10
Take Care Health Congratulates Itself For Engaging Its Clientele
On the other hand, what else are press releases for, anyway?
Exceptional Patient Experience Delivered at Take Care Clinics at Select Walgreens
Before we continue – who knew you could grow up to be a customer engagement scientist? Sounds cool.
We understand Take Care Health’s and Gallup’s enthusiasm for the kind of customer engagement Take Care clinics are generating. What we don’t understand is this: given retail clinics’ focus on episodic care, and their explicit public commitment to supporting customers’ development and/or maintenance of relationships with primary care physicians, shouldn’t ‘scoring’ engagement success based on actual customer return visits be viewed as ambiguous at best? (We can set aside that, as a practical matter, Take Care will have a tough job gathering objective evidence that customers have in fact followed through on care recommendations from their Take Care visits).