Welcome to this first column in a mini-series on this MAXI topic.
After that dreadful ER experience with my son, I have been on a mission to explore and shed light on emergency care problems locally.
What I now understand is that emergency care is but a piece of and reflects our bigger broken healthcare system. The issues here in Thurston County sadly plague many communities. Experiencing a different quality of care at Overlake Medical Center in Bellevue offers hope for something better being possible in these times and in our community. New ways to offer care are being instituted locally, columns August 22, December 12 and December 18. In time we will know if these innovations offer definitive solutions or are at least Band-Aides, for now.
The overall healthcare mess is reminiscent of the story I wrote about the prescription opiate crisis discovered and resolved by a hero in our midst, Gary Franklin, M.D. WA Department of Labor and Industries (Part 1 and Part 2).
It was solved by
1 - identifying what was happening (disabled young men’s widows were applying for spousal death benefits as their husbands were dying, from opiates as it turned out), 2 - how it happened, and 3 - by taking steps to stop and solve the deadly problem. It took an intensive COLLABORATIVE EFFORT between the medical profession, state departments, and legislatures (nationwide) to change. No magic bullets. It took TIME, dogged persistence (thank you, Dr. Franklin and team!) and LEGISLATION.
It will take all of that and more to fix our broken healthcare system, which is substantially BIGGER and MORE COMPLICATED.
I am no expert but here is what I observed.
It all started in the years I practiced medicine (1976-2020). There were three things I witnessed in the early years that were memorable and impactful:
1 - Circa 1979 - my Infectious Disease preceptor (i.e. teacher) was actively recruiting colleagues to sell their practices to the hospital where I trained (now called Providence St. Vincent Medical Center), sincerely believing this would improve healthcare and our practices. He was sold on the belief that turning over the day-to-day running of our offices to business administrators, would free us of that ‘burden.’ I felt sickened by both this concept and his religious-like passion, which won out as we know it now.
I heard last week in a house legislative hearing that currently 50% of WA physicians are employed by corporate healthcare systems. More on this later in the series.
2 - Towards the end of my 1980-83 residency, I was introduced to St. Vincent’s new CEO, an MBA-trained administrator, who in his formal business suit and manner, seemed nothing at all like the Sisters (nuns who were professional chaplains, nurses, and leaders) who previously sat in those administrators’ chairs.
3 - Circa 1984-90, my early years in private practice, I felt similarly ill when health insurance contracts became increasingly more complicated to assess, navigate and eventually bill. Issues 1 and 2 were nails in the coffin of the private practice of medicine.
There are many who ‘get’ a lot more than me about the nature of our healthcare problems. Stay tuned as I intend to share what I learn from them in future entries for this series.
Currently, 90% of hospital care in our state is in corporate-run health systems. Overlake Medical Center is not one of these, by the way.
This is our state capital, and the legislature is in session right here and right now. I wondered… What are the healthcare committees up to? So, I attended one hearing each in the House and Senate and learned… They are up to A LOT!
I listened to a whole array of dedicated, passionate, highly intelligent, and educated professionals who are working hard with the intent of healing and bringing justice to our healthcare system. I heard policy writers, leaders from organizations researching healthcare systems, lawyers and their aides writing legislation, and legislators themselves speak on behalf of (or against) proposed legislation. Sitting in those hearings, someone with minimal prior exposure to law-making, was brilliant, inspiring, and hopeful.
In this session of the Washington State legislature, there is legislation being introduced to address every aspect of what is broken. Enacting laws through legislation and funding agreements had a role in creating this mess and will likewise play an essential role in excavating our way out.
There are or will be no magic bullets for improving the healthcare system. The legislative process is complicated and takes time. Changing something as big as our healthcare system will as well. Such change will require a climb of many steps, one after the next, until gradually, many of the broken parts of our healthcare system can be healed.
I feel it is important for us to be informed and understand what is going on with our health and what to do about it. I also feel that in this time of brokenness, an informed and activated public will be important as we press for better healthcare. We do, after all, still live in a democratic country.
Stay tuned for what I learn, meeting with policy researchers, attorneys, writers, legislators, and more as I roll out this series. Join me in sharing both hopes that we have reached the darkest place in the healthcare tunnel and that we may at last be moving toward the light.
Debra L. Glasser, M.D., is a retired internal medicine physician in Olympia. Got a question for her? Write drdebra@theJOLTnews.com
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