The Executive Suite: Is good care good enough?

Thursday, September 1, 2022

Is good care good enough?

Good care is good enough until you need great care; that’s the quandary. How do you know if you need great care before it is too late? Too often, you don’t. And most patients certainly don’t.

I have thought a lot about this dilemma, as it seems I often am swimming upstream in today’s society. I am a long-term proponent of the patient/primary care physician relationship. I feel I am increasingly in the minority. Many of my friends and co-workers have a relationship – and I use ‘relationship’ very loosely – with an urgent care clinic. They don’t have someone in their corner if and when things get tough. The absence of an ongoing relationship with a primary care physician will contribute to inefficient care; and perhaps worse. After all, good care is good enough until you need great care.

An estimated 25% of Americans do not have a primary care physician.I think this estimate is low, because many patients who say they have primary care list a practice rather than a provider. It isn’t the same.

Telehealth care via my health insurance company’s preferred vendor is more convenient and keeps me out of a germ-filled waiting room; at least that’s what their marketing literature professes. It is a short-term strategy for providing cost-effective episodic care, just like fast food is a short-term strategy for providing a quick meal. I am not convinced, though, that detached telehealth care will save money in the long run. I can eat fast food every day and won’t pay the piper for years; but the time will come when I have to pay the piper. The same goes for episodic healthcare. In each instance, we are trading short-term convenience for long-term consequences.

I understand the position of the insurance company and the fast-food company. It is a short-term position to optimize their profits, albeit at the expense of the long-term health of their customers. When the consequences of these short-term strategies come to bear, the customers will be someone else’s problem: Medicare’s. And that means each of us will be paying the price. Think about it. One cannot go back in time and change the past to make the future better, yet the premise of health insurance companies is that it doesn’t matter – at least to them.

You cannot make a horse drink, yet you can make lukewarm water more convenient than chilled water. I fear that is what is happening today in healthcare. Insurance companies, urgent care clinics, global telehealth – good healthcare is so convenient and accessible that great healthcare is an afterthought until it is needed.

Primary care practices are combating this trend by offering extended hours, weekend hours, and such. It is needed - and as a patient, I can tell you - it is very much appreciated. The ship sailed during the pandemic and is not coming back to port anytime soon. Embrace this new reality where convenience outranks quality, but don’t shortchange the sacrosanct patient/primary care physician relationship. It remains our future. It’s why you do what you do, and it is the hope for healthcare going forward.