Saturday, April 7, 2012
Family Medicine Activist: Patient, Doctor and Prescription Tension Mounts
Changes continue in the wrong direction in healthcare and health care. Confusion increases about how to get continuing medications for patients at the start of each new year. New insurances, new rules. New deductibles, new co-pays. High deductible HSA's lead to more frustration for persons who aren't used to paying more than $20 dollars for health care encounters. More unemployed patients without insurance (who pay nothing when seen and have little chance of ever paying) are showing up. Tension mounts.
I take ER call for unattached patients for follow-up. Someone accidentally started faxing me the ER record for ALL unattached patients in the ER on my on call days showing me that about 20 uninsured, unattached patients hit our small county hospital daily. I know that another Family Physician is retiring at the end of May near the hospital, exposing another 2000 patients to a scramble for a Family Physician. Tension mounts.
It took me fifteen minutes to figure out one chronic med for a senior citizen who got a brand Rx from a specialist but we immediately had the POA (daughter) calling us about the excessive cost (first drug) then the denial of second Rx for unspecified reasons. Six phone calls later to and from my office yielded brand name Rx three. The third Rx was affordable, but caused a significant side effect in this patient. The Pharmacy Benefits Manager of her insurance company said she had to again take the medication that caused the most intense negative reaction because they have no record that the patient was prescribed the medication (since it was sample pills given by another specialist). This type of bureaucratic response is dangerous and worrisome. We need more flexibility in the persons making decisions about medication formularies and how those decisions are communicated to patients and physicians. Help! Tension Mounts.
Tension mounts. Tension is everywhere. Even in poetry. Here's an interesting piece about tension in poetry that I found meaningful when thinking about tension. It's from a local blogger (with poetic understandings)-Grace Curtis. N2Poetry: Tension in Poetry by Grace Curtis