"How To Improve Your Health Care" by Allen Weiss, MD, MBA, President & CEO

How To Improve Your  Health Care

October 1, 2013 - No one wants to be a patient, but if you are—or if you have a family member who is—it would be nice to know what to ask and how best to be treated well.

Asking questions, being involved, and staying informed are all good characteristics of patients who have better outcomes. Health care is not limited to diagnoses, drugs, devices, and prognoses. More than just healing, long term quality of life should be the goal of the entire team, including the patient.

The “patient’s experience,” is a measured metric which is followed by many of the “payers,” including Medicare. We at NCH have had an objective improvement as measured by an independent third party, Press Ganey. About half of our discharged patients receive an anonymous survey approximately seven to ten days later. About one third of the surveys are returned and include comments which are carefully studied and then shared with the care-givers so we can all learn and improve or feel grateful about the very positive comments.

Asking why a test is being done, inquiring about the results, and getting an understandable answer are the minimum questions and actions of a good healthcare interaction.

Understanding who will be caring for you is an important matter, since it could be the physician, physician’s assistant, or nurse practitioner—all possibilities these days—either alone or in combination. When NCH becomes a teaching institution, which is anticipated in 2015, we will have interns and residents in Internal Medicine. We may also have 4th year Surgical Residents from Mayo Clinic rotating with our NCH Physician Group surgeons next year. Having a program and asking the right “who,” question helps everyone communicate better. Clearly, having a team with individual roles is the way modern care is going. You just need to know who is on your team and their respective function.

Equally important is having everyone on the team understand and share your history, current and past medications, and your overall desires about the diagnosis, plans for treatment, and prognosis, as well as possible. Clear communication between patient and the team avoids a multitude of problems.

Other resources are typically available, including social service and therapies of all types: physical, occupational, speech, dietary, and even a pharmaceutical review by a knowledgeable pharmacist. Everyone is anxious to assist and when coordinated by your primary care physician, everything seems to go better.

Asking for a review of the first explanation is not uncommon and, in fact, makes great sense when you are stressed out due to your illness, in an uncomfortable and relatively new location and generally in auditory shutdown. The trauma of being admitted or discharged from a hospital is difficult. Adding to the blur of moment are, typically, new medications, perhaps a surgery, a new and different sleeping and eating environment—all justify a review of the explanation as often as needed. No doubt everyone is better off when we all know our roles. Also, having a team with members who have different skills is healthy and will provide a better outcome. The team simply needs to be coordinated, have a plan, and be cohesive. And the patient must be personally involved.

Past Health Advice Articles

Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.