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Improving Community Health

Hospitals have long been places people go when they are ill, going to have a baby, or to get a test.   

Not-for-profit hospitals, in order to keep that IRS status, have been required for the past few years to file a Community Health Needs Assessment (CHNA) every three years, along with a plan to address health needs, such as diabetes, high blood pressure, and obesity. 

Healthy Populations

Our hospitals today are concerned that "health care" means fixing health problems that people have.  After all, that's how hospitals have traditionally been paid. Replace a knee joint.  Get paid for fixing the joint. The more hospitals did, the more they got paid.  

That is changing with reimbursements from Medicaid and Medicare based on, for example, whether a patient stays out of the hospital within 30 days of discharge. Medicaid and Medicare reimbursements can account for half or more of all hospital revenues.  

Diagnostic Error

Whenever I go to my primary care physician with a complaint, I want the physician to do something to help resolve the complaint. The physician may say that in time the problem will go away. It is nothing to worry about. Or the physician may ask me to do more exercise and eat more nutritious meals. The physician can also write a prescription and ask me to come back after I’ve taken all the pills - if I don’t feel any better. I may be asked to do a test involving a blood or urine sample. I might be given a referral to another physician.

All the while, the physician is trying to select among possible diagnoses, in order to label my complaint. There may be one diagnosis or multiple diagnoses. This is not always an easy task for the physician.

I can also go onto the web and try to diagnosis myself on WebMD’s Symptom Checker. I might go to the drug store or health foods store or go online to see if something is available that help resolve my complaint. I can also ask my friends if they have had a similar complaint. The physician is trained in diagnosis and I’m not. So while I may look online or talk with my friends, I’m going to rely on my physician to help me.

Now, I’ve heard about diagnostic errors, so I want to make sure that my physician and the physician to whom I am referred gets all of my basic information right and that both physicians are communicating with one another about their conclusions. One version of a diagnostic error is whether a diagnosis is delayed. Or the diagnosis may be wrong.

What can patients and physicians do to assure that a diagnosis is made as quickly as possible and that the diagnosis is correct? Click here to let me know your ideas.