Healthcare Pecking Order

Healthcare is in crisis. Hospitals are merging, rural hospitals are closing, doctors are quitting, patients aren’t paying. We need to get back to basics for this bloated, embattled  industry.

Number 1 is Rescue and Repair

Trauma Care

At the top of the list is Trauma Care. That has long been the primary job of physicians and staff.  The ER is the normal entry point and the case is life-critical.  This often requires an OR at the ready. If the patient is bleeding heavily, not able to breathe, heart attack, etc.  The rescue is to keep the patient alive; the repair is to do surgery or administer drugs and “repair” the patient to stabilize and heal.  If the patient isn’t breathing, you will need to do CPR immediately; don’t wait for the EMTs.  Life-critical trauma care is the only resource we need to be available.

Now comes the expensive part. Too many expensive tests, monitoring and long hospital stays need to be avoided. So, malpractice law needs to be reformed to eliminate defensive medicine practices. I would eliminate malpractice suits completely and leave discipline to the local Medical Societies.  If we fix this, maybe the healthcare industry will survive.

Number 2 is Scheduled Surgery

Having a hernia fixed requires an OR.  Baby delivery in a hospital is common. If the baby isn’t turned, or is tangled up in the umbilical cord, somebody needs to either fix it or make the call to deliver via caesarian surgery. That’s when the sonogram should be taken.

Number 3 is Normal Care

For care of things that are not life-threatening, most things can be nursed at home and you can wait until morning to go to the doctor.

If little Johnny falls out of a tree and breaks his arm, put cold packs on it and take him to a doctor’s office if you can get one.  The ER is 24x7, but it is 7 times more expensive than the doctor’s office or emergency care office.

If there is EXTREME PAIN it could be an appendicitis or worse, so the ER is the place to go.

Home healthcare is the future for most patients who suffer from progressive disease.  Chronic illness patients need to shop around for dialysis, etc.

Number 4 is Recovery Therapy

Physical therapy can help with brain injury cases, but they tend to be “stretched-out” way beyond what’s needed. Also, they won’t catch things like post-op infection control or frozen shoulders. You need specialized help for that.

Number 4 is Counseling & Mental Health

Decades ago we didn’t have much of this.  This was an out-of-pocket expense.  Most of this is up to the patient and can be done for free. There are AA groups and other resources. A few years ago, counseling for addictions was stretched out beyond what was needed, but now it’s short. Real psychotics are either in hospitals or in elective office.

Number 5 Prevention

Prevention is really the responsibility of the patient and shouldn’t require any cost. There are health fairs where you can get a sonogram of the plaque in your arteries, etc.

Trends

Baby delivery Home birthing in blow-up water pools is being done by experienced visiting nurses, but they need to bring a sonogram machine and a fast car if the baby is wrapped up in the cord or is positioned to come out feet first.

The internet can answer any questions you have about medications, symptoms, etc.

Norb Leahy, Dunwoody GA Tea Party Leader