Healthcare Tomorrow

The Cure0

One of the things I love about healthcare is that communities of patients and caregivers come together to do more than treat conditions.  They create support groups, they advocate for research dollars, and they spread the word about the medical conditions that bring them together.  For the patients and their families, the medical condition, be it cancer or MS or Down Syndrome, defines their lives.  It becomes a part of who they are.  For the caregivers, it is the passion to care and cure that drives them. 

They become experts and advocates. 

But what happens when the “fight for the cure” has unintentional side effects?  What happens when there are fewer and fewer people with the condition?  What happens to the community then?

Such is the problem for patients and families with Down Syndrome.  In a wonderful video on the New York Times website, journalists Amy Harmon and Kassie Braken explore the shrinking world of children with Down Syndrome.  With the early detection of down syndrome in fetuses and the extremely high termination rate of those pregnancies, the prevalence of children with the condition is sharply declining.  And with that decline comes a loss of shared experience and knowledge about raising children with Down Syndrome, about their life expectancy, and about who they are as individuals.  In the case of Down Syndrome, “finding the cure” (indeed termination is in no way a cure) comes at the diminishment of the community. 

Healthcare is full communities that are fighting for cures.  The fight for the cure gives purpose, and sometimes meaning, to people that are struck, at random it often seems, with disease.  About once a generation we are able to cure a disease and with billions of dollars spent on medical research each year that rate is bound to increase.  As we celebrate the victory of our medical discoveries we need to remember to care for those that weren’t lucky enough to come after the cure, those for whom the cure is bittersweet.          

Posted: Doing Right

Sorry Works1

SorryWorks - Yesterday I came across a great organization called The Sorry Works! Coalition (www.sorryworks.net). Sorry Works encourages healthcare providers to fully disclose medical errors to patients and their families right off of the bat. The result, they say, is that malpractice litigation is avoided in most cases, because the patient and family get what they want from the beginning - an admission of responsibility and an apology.

This is not a new concept (I have seen literature on apologies before), but I was surprised that I had not heard about this organization until now. With all the fuss about medical malpractice costs over the past few years, why hasn’t this program received more attention? My guess is that the medical malpractice insurance carriers believe that they will see a bigger impact on their bottom-lines from capping awards. Indeed, as Health Affairs has recently confirmed, the increase in medical malpractice premiums over the past number of years far exceeds the payouts to plaintiffs. Where do you think that money is going? (Please don’t read that I am anti-profit - every for-profit company has that right - but one of healthcare’s key problems is that it’s costs are out of control and money taken out of the system by corporate profit is money not spent on improving the nation’s health status.)

This concept just makes sense and it is the right thing to do. Organizations need to take a serious look at this and ask themselves why they are letting defense attorneys and risk managers get in the way of doing the right thing. If SorryWorks really works, then everyone, providers and patients, will be better off.

Posted: Doing Right