The complex business of medicine is continuously evolving. As insurance companies, doctors and patients align themselves with different health care systems, the competition to keep patients has heightened to a disturbing level. This is not necessarily best for the patient. Here is my story illustrating this new phenomenon.
A female patient came to see me last month complaining of chest discomfort. Her stress test results suggested a major cardiac issue. Further diagnostics, specifically a cardiac catheterization, were needed. I called a colleague who specializes in this procedure, and set it up for the following week. Together, my patient of 15 years and I discussed her concerns and expectations. Then off she went to the next part of her journey. Her voyage through the health care system turned out more complicated than anticipated.
As it turns out; my well-respected colleague would not perform the procedure because this patient was an employee of a competing heath system. Thus, it was financially advantageous for her to have the procedure in that health system by their doctor, in their hospital. This often happens in today's world and is not necessarily a bad thing. It can save money while still providing good care. Her medical records were sent to the new doctor, and I waited to hear the outcome of her heart catheterization.
To my surprise, when this patient returned for a follow-up visit, I found a significant change in her examination. There was now a scar running down her chest because she had a coronary artery bypass operation. No information was provided to me, her long time cardiologist. I was told nothing about her surgery, medication changes or complications during her hospitalization.
Her records had been entered into an electronic medical record and automatically sent to her "new" cardiologist, who was a member of the health care network where she had surgery. This action ignored the fact that I had a long-standing clinical relationship with the patient and many of her family members. More importantly, it disregarded the patient's request that I remain her cardiologist.
Her surgery was seen as an opportunity to "capture" her into a new health system. Health care organizations tend not to share information outside of their own nest. The special relationship between a doctor and patient is being challenged by more and more cases just like this one.
What can you do to prevent this from happening to you? Become your own advocate in your journey through the health care system, insist that your physicians communicate, always make sure that you receive and understand your test results, and remember that all medical information belongs to you, and is not proprietary to a particular health care system.
In this situation, no real harm was done. Thankfully, my patient has progressed with no major complications. Our doctor–patient relationship will continue once she fills out a record request form so that I can retrieve her medical records the old fashioned way- by fax or snail mail.
In time, I hope that systems will be less concerned about capturing new patients and retaining control of data. Instead, the focus should be directed toward improving the health of patients and respecting the doctor-patient bond. Health care professionals cannot afford to forget the value of common courtesy and how important it is to provide a personal touch.