COMMENTARY

A Healthcare System That Works

Karen Donelan, ScD

Disclosures

May 06, 2005

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On a hot, Sunday afternoon last summer, a dear member of the family became increasingly weak and progressively unresponsive. Much to our surprise, the healthcare system worked remarkably well. Why is our story different than so many others?

  • Timely access: The PCP [primary care physician] answering service worked; humans answered the phones; the doctor met us immediately upon arrival in the emergency room; admission happened in less than 30 minutes.

  • Compassion: From the receptionist who told us to wear sweaters, to the technician who provided hugs to patients and our children, to the doctor who gently raised the issue of how far we should go to save this critically ill patient, people cared and they showed it.

  • Shared information and decisions: At every step, the doctor shared the differential diagnosis, details on evaluation and treatment, the time it would take, and the price they would bill. Then she asked what we wanted to do. Later we shared research and data by email and cell phone about possible causes of the internal hemorrhage and ITP (idiopathic thrombocytopenic purpura). We felt a part of the care team. And the team shared information with each other -- another unexpected event. They called with updates and didn't always wait for us to call them.

  • Expertise and the right tools: The doctors were highly trained, usually correct, and worked in a clean, modern facility that made their jobs easier and our visiting more pleasant.

On the fourth day, we brought our dog, Rico, home.

We have had many family members hospitalized. We marvel that our dog was able to receive seamless, high-quality healthcare that was accessible, compassionate, and expert with a fully disclosed price and plan of treatment.

Wishing you human healthcare as great as my dog's . . .

That's my opinion. I'm Dr. Karen Donelan, Senior Scientist in Health Policy at the Massachusetts General Hospital.

Readers are encouraged to respond to George Lundberg, MD, Editor of MedGenMed for the editor's eye only or for possible publication via email: glundberg@medscape.net .

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