Are Americans the worst patients in the world?

“Recriminations tend to focus on how Americans pay for health care, and on our hospitals and physicians. Surely if we could just import Singapore’s or Switzerland’s health-care system to our nation, the logic goes, we’d get those countries’ lower costs and better results. Surely, some might add, a program like Medicare for All would help by discouraging high-cost, ineffective treatments.

But lost in these discussions is, well, us. We ought to consider the possibility that if we exported Americans to those other countries, their systems might end up with our costs and outcomes. That although Americans (rightly, in my opinion) love the idea of Medicare for All, they would rebel at its reality. In other words, we need to ask: Could the problem with the American health-care system lie not only with the American system but with American patients?”

Atlantic July 2019. https://www.theatlantic.com/magazine/archive/2019/07/american-health-care-spending/590623/

Anna Loska Meenan, who lives in the Rockford area and used to be on staff at the Mt. Morris clinic, says:

This excellent article explains why Medicare for All in the US would quickly lead to one of two scenarios: Either the health care system would be immediately bankrupted, or the resulting rationing would lead to riots in the streets. Having been involved in health care, I can confirm that this author speaks the truth, and from conversations with docs who are still seeing patients, I can see that things have only gotten worse since I left medicine 10 years ago.

My letter to a grant recipient at OSU

Today I noticed in OnCampusToday you’ve received a handsome grant of $2.27 million from NIH for “patient engagement.” Congratulations.  I’ve read through your publications, and you have had an impressive career. Although I don’t know what “concept map to define capacity for engagement” means, I would like to comment on patient portals as a means to engage patients in their own care.

I hate them.

My husband has 2 doctors, 3 if you count the cancer specialist whom he rarely sees, and I have 3, family, ophthalmologist and cardiologist. We share the family doctor. Each practice uses a different portal system for finding our lab results, asking questions, tracking meds, etc.  But the worst feature is their sending us advertisements! I don’t know until I’ve made the effort to get in—not easy—why I’m being contacted. What a mess! Fortunately, I don’t think my ophthalmologist uses one, because he’s the one I see most frequently. When I ask him to send a record to my family doctor, he uses a fax.

Recently we received a notice from our financial advisor suggesting we have our own “portal” for his financial services, and I fired back, Absolutely Not. Face to face is always better. I’ve not had eye-contact with a doctor since Obama imposed the horribly expensive EMR system, which had never been tested for improved care or cost reduction. One of the Emanuel brothers just thought the tech industry needed a pay off. My medical records could be transported faster by carrier pigeons from Riverside Hospital to Dr. Jennifer Bush, 2 miles away. And I hold no hope that patient portals will improve my care, at least not the ones in use by any of our doctors.

And by the way, how secure are these portals? Who designs them to be unworkable? Are they more secure than large medical practice records? Two years ago my husband’s urologist’s practice was hacked, and thousands of records exposed with all the personal data that goes along with that.

I have 9 blogs, I’m on at least 4 e-mail discussion lists, I’m on Facebook, I read a lot of medical, political, technology and religious information web sites, and I’m a retired librarian (veterinary medicine) who formerly taught classes in data base searching and information skills.  I used to teach “older learners,” which is anyone over 25.   You need a system that is easy for 80 year olds or admit this technology does not have the capacity to engage.

Norma J. Bruce

OSU Libraries faculty, retired

Can waiting room chairs accommodate anyone larger than size 10?

Yesterday I didn't blog, but I was a client at a clinic that is two  years old (the practice is older, and so is the building, but the practice moved down the street and remodeled this building). Modern everything--lots of glass and exotic lighting fixtures--except the seating. Of ca. 30 chairs, only one would accommodate an obese, or even mildly overweight patient or care giver. 29.8% of Ohio is considered obese; 32.6% of Columbus.  http://stateofobesity.org/states/oh/ Ohioans need to eat more fruits and vegetables, but I don't think discouraging them with chair size is the way to do it. Also I noticed that the trendy interior decor made it impossible to read the equally trendy light gray titles and instructions on the glass doors from the hall ways. I started out in the wrong space.  Just getting old and crabby, I guess.

This strikes me as odd because if I walk through a residential furniture store, the couches and chairs are huge.  We can hardly find one that fits our body size; yet office furniture seems stuck in the 1950s size ranges.