Doctors are working harder and longer, all while patients can access them less.
are identical, and therefore redundant, to the previous ones. The practical result is that doctors spend hours digging through disorganized charts, sleuthing for critical patient data that gets buried under an avalanche of noise. In an era where multibillion dollar software promises to ease data-sharing, the process for providers to input and find health data remains manual, labor intensive, and error prone.
Our current solution to these technologic glitches is leaning on people to serve the needs of the electronic charts. It was supposed to be the other way around. Support staff becomes crucial, yet patching logistical holes often falls to doctors. Recently I prescribed a medication that took 22 clicks, waiting on hold with an insurance company, tracking down a denial letter, writing an appeal, documenting all these phone calls, and keeping my patient apprised through messaging.
Managing a patient’s case in this fragmented system requires better tech and team support. It also requires time. In comes the final mismatch: between what is paid for and what medical care requires. Despite pushes in recent years for payment models that focus on value, the vast majority of health care organizations in the U.S. still operate according to fee-for-service. Here, health organizations or doctors get paid based on discrete services they provide.
Fixing this crisis will involve profoundly rethinking how we allocate the resources we already have. For years, the labor needed to assemble disparate pieces of a fragmented health care system continued to climb, while the party line to doctors remains the same: Just one more thing. One more click. One more message. One more workaround. Just squeeze it in, we don’t know how, but do it anyway, and do remember if anything goes wrong the responsibility is fully yours.
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