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.
19
Aug 10
Retail clinics and public policy
It’s been a relatively slow summer, newswise, for retail clinics, and our vigilance for news items has undoubtedly flagged a bit. So imagine our delight to have news of this report show up in our mail this morning:
Policy Implications of the Use of Retail Clinics. August 2010. Authors: Robin M. Weinick, Craig Evan Pollack, Michael P. Fisher, Emily M. Gillen, Ateev Mehrotra.
We haven’t yet seen any media releases for it, and thought you’d like to know about it.
Dr. Mehrotra can lay claim to being the most recognizable retail clinics expert among clinicians and academics.
We’re poring over the report as you read this. Watch for our review in the next few days.