Coordination of health care

June 6, 2012

I suspect no one coordinates my son’s blood work because none of the doctors can bill for case management.  Luckily the blood work person (who treats him like he’s her grandson or something) took two vials the first time and was able to add the second doctor’s test as just another sticker on the tubes instead of drawing more blood later.  And she helped me straighten out the coordination of insurance benefits issues complicated by her substitute’s apparent omission of entering the new insurance information I gave the lab last time we were in and she was away on vacation.  Then the pharmacist made the point to us that the co-pays would be lower if the doctor wrote the prescription differently, which illustrated to me again (I’ve seen it before about other aspects of prescription-writing) that doctors don’t take into account health insurance rules.

My point:  in theory this doesn’t have to be so hard, so much of it doesn’t have to fall on the patient or their care manager, but in practice there will never be the efficiencies we need until more attention is paid to how the system actually works in practice — who knows what and who is talking to (willing to talk to) whom.  Efficiency depends on elements that just aren’t there, from conscientiousness to cognitive ability to computer software training to billing incentives to time and willingness to communicate to other parts of the care providing team.

My son is pretty cool about the whole thing, and I guess for me, I am hoping he may actually see some improvement in his condition from all this recent flurry of activity.  And maybe this is my modern-day version of the story of those blind men with the elephant I so love — a lesson in how it’s all about an opportunity for communicating.

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