Here’s a typical scenario when you have a medical problem. You go to your doctor’s office, then have to run across town to a lab for a blood test and then you also have to get an appointment for an X-ray or MRI. There’s a good chance this will all require a phone call — or a lot of phones calls — with your insurance company.
It’s a hassle and it’s time-consuming.
But for many people it’s even worse than that.
That’s because about a third of working adults say their jobs don’t come with paid sick leave, according to results from the latest poll by NPR, The Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health.
…Our poll found that 32 percent of people in the U.S. are like Hesse. They don’t get any paid sick days. And 24 percent have no paid vacation time.
So unless they work odd hours, people without either benefit lose income if they want to take care of their health.
That’s a real problem, but it’s not the only consequence of what Dr. Victor Montori of the Mayo Clinic refers to as the “work” of being a patient.
He says the health care system is designed for the convenience of doctors — and the result is that patients find themselves running to doctor’s offices, labs, imaging centers and back, often carrying their records along with them.
“That is not an organization of care that started by thinking, ‘How do we meet the needs of the patients?’ ” Montori says.
The current setup was created at a time when people saw a doctor for an injury or infection. By contrast, today most people by middle age are dealing with a chronic condition that requires regular care.
…”For people with chronic conditions, the health care system is blind to their context,” Montori says. “In particular, it’s blind to the work of being a patient and the capacity that people have to shoulder that work and make it happen.”
And if patients don’t do everything right — if they don’t get their tests, or refill their medications on time, or go to follow-up appointments — they are deemed by the health care establishment to be “noncompliant,” he says.
“We just decide that it’s the character of the patient that is to blame and move on,” Montori says. “Rather than reviewing our own behavior as a health care system and see how is it that we have created so much work for people that they no longer can do it.”
Montori and his colleagues are now reviewing that behavior and trying to determinehow to make the health care system more responsive. One approach is to put health care providers in schools and workplaces and to make them available during evenings or weekends.
Read the full article.