What is quality healthcare for the uninsured?

Last week, when I complained about writer’s block, someone (Hildy Gottlieb of the Community-Driven Institute) suggested that I make a list of everything that’s keeping me awake at night.

“Choose something on the list and write about that.”

My list is long. Given the state of the economy and the increased need for our services, I frequently have trouble sleeping. However, a discussion that I had a few days ago keeps coming to mind. It was a discussion about what defines “quality” when it comes to patient care at Good Samaritan Clinic.

Is three weeks too long to wait?

Right now, our schedule is booked about two weeks out at the Clinic. A new patient would probably wait close to three weeks for an appointment. We normally can work someone in within hours, if necessary. Otherwise, patients are seen by appointment only.

For most of our primary care doctors, we schedule twelve patients per half-day. That is twenty-four (24) patients per day. Some days all of the patients show up. Other days, quite a few are “no shows”. The receptionists try to find the middle ground when scheduling patients. They also know which patients are more likely to not show up for appointments, so they schedule an extra one or two, accordingly. However, on days when all the patients come for their appointments – and extras show up needing immediate care – things get very hectic at the Clinic.

Doctors enjoy spending time at Good Samaritan Clinic. They can spend more time with our patients than is sometimes feasible at a “for profit” clinic. Since we make no financial profit from seeing patients (it actually costs US to see them!), the meter isn’t running. In addition, most of our patients have multiple health issues. They may have diabetes AND high blood pressure AND asthma AND high cholesterol AND a thyroid disorder. For many, add a history of alcoholism or homelessness. Throw in a little depression for the majority of them. Add to that the fact that many haven’t been to a doctor for years, and you can imagine that the result is a complicated medical situation. Definitely not something with a cookie-cutter solution.

Most patients enjoy the extra time and conversation with the doctors. They leave the Clinic feeling like a person, not a number (or so they tell us).

“Quality of time” versus “quantity of patients”

So – my question is this: What is quality healthcare? Are we doing our patients a disservice if they must wait two or three weeks for an appointment? Should I require the doctors to see more patients each day so that future appointments are scheduled sooner? If each visit were five minutes shorter, we could accommodate eight additional patients every day. A three-week wait could be reduced to just two weeks… but is it worth it?

When YOU go to the doctor for a non-urgent visit, would you prefer to wait fewer days for the appointment or have the physician spend unhurried time with you, building trust and possibly finding solutions that will benefit your future health?

I guess my question really comes down to this: Given a choice, would you rather have more days until your doctor’s visit or possibly more days added to your life?

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One Response to What is quality healthcare for the uninsured?

  1. Brenda Hook says:

    Kirby,
    Thanks for the link to your site. I’ve added a link to your blog in my “Blogroll” section.

    We have been blessed with some very committed volunteers here at Good Samaritan Clinic. Two of those volunteers have overseen our prescription assistance program since the clinic opened. As you know, the paperwork can be overwhelming and each pharmaceutical company has different qualification criteria. Our volunteers complete the applications and navigate the process on behalf of our patients.

    Approximately 1,000 of our patients are receiving their long-term medications for free through our Medication Assistance program. None of them could possibly afford the medications themselves, and we could certainly not pay for all of those prescriptions, either.

    I hope to devote a future post to the Prescription Assistance program specifically at our Clinic. With your permission, I will refer readers to your blog for additional information.

    Thank you for your input.

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