Body Part Medicine & Disconnected Care

I’m addressing what I’m calling “Body Part Medicine & Disconnected Care” in reaction to a national survey released by the Campaign for Better Care. The survey of over one thousand adults 50-plus years found that older people who are struggling with one or more chronic conditions also struggle with poor care coordination and inadequate communication among the doctors that treat them. It’s due in large part, as a result of specialized medicine.

It’s not uncommon for those in their sixties to juggle doctor’s appointments for two or more chronic conditions. Diabetes, heart disease, high blood pressure and arthritis can catapult a rather “healthy person” into a world of blood tests, self-administered blood pressure and glucose readings along with a multitude of medications. In all likelihood, specialists will treat each of these conditions, for example: a cardiologist for heart disease, rheumatologist for arthritis, endocrinologist for diabetes and an internist to monitor blood pressure and diagnose any new problems or make referrals to other specialists.

Each of them will likely order tests like x-rays, blood work, CT scans, MRI’s and they’ll prescribe medications to treat each condition. Unless, all of these doctors practice within the same health care system, they can’t access the results of each other’s test results. And, in some cases, unless the patient speaks up, they’ll order repeat tests unaware that it was ordered by some other treating physician. Or, if the patient doesn’t share his or her complete list of medications, a doctor may prescribe a medication that should not be taken with another drug or they may prescribe the same medication as has another physician. Thus, a patient may unwittingly wind up taking twice the dosage. Sometimes this happens, when a patient thinks a drug in a generic form is different from a drug written under the brand name yet it’s actually the same drug. Patients using multiple pharmacies are more at risk for this to occur because the pharmacist is less likely to pick up the duplication.

Here are some key findings of the survey that may alarm you:

• On average, 40 percent of the respondents reported that their doctors do not talk to them about potential interactions with other drugs or over-the-counter medications when prescribing new medications.

• Forty percent of those with multiple chronic conditions act as the chief communicator among the doctors they see because the physicians don’t talk to each other.

• Three out of four respondents really wish their doctors would speak to each other to better coordinate their care.

• One in eight respondents had to retake a test or procedure because the doctor or hospital did not have the earlier results.

• Three-quarters of heavy users of the health care system have left a doctor’s office or hospital confused about what to do at home.

• Three-quarters of adults 50 and older say they are worried that the quality of health care services they receive will get worse in the future.

• Twenty percent reported that they had to unravel conflicting information from different doctors.

So what about you? Do you have a story to tell or suggestion to make on how patients and doctors can better sort this out?

In the meantime, always keep an updated list of your medications and bring it to every physician visit to share with your doctor. Also, ask for copies of your test and procedure results and bring those with you to every doctor visit. Let the doctor know of your other medical conditions and the names of those physicians treating you. Bottom line? It’s all about you. You are in charge of your health care.