Monday, October 17, 2005

Instructions not Included

Instructions not Included - Judy Foreman, a freelance writer for the Boston Globe, LA Times, and other newspapers, wrote a great article recently entitled A Visit to the Doctor. The article advises patients to, among other things, prepare questions, take a friend, and leave with a plan of action. As a provider of services, the article reminds me of how complicated we have made healthcare.

As I was leaving the hospital today, I saw a patient in our radiology waiting area holding our patient's rights form newspaper-style, just inches in front of his face. I couldn't help but wonder if any of the 8 pages of small-font, HIPAA jargon made any sense to him. These aren't the only hospital documents that befuddle our patients. Hospital bills continue to live in infamy over their mysterious codes, subtotals, and "descriptions". Just last week an article in the New York Times compared deciphering hospital bills to confronting a Kafka-esque faceless bureaucracy (I can't say that I am a Kafka exert, but it is a dramatic analogy). Fortunately, the good people at the Patient Friendly Billing Project have been trying to simplify and standardize hospital bills for some time now, but the shear complexity of medicine (DRGs, ICD-9, HCPCS codes) and dated technology have kept many hospitals from making bills easier to understand.

The most unfortunate aspect of our complex healthcare system is that it places an additional burden on patients that are already struggling with illness. Hospitals should always be aware of this and make concerted efforts to ease our patients into and through the system. If we can't make the system less complex, then we can at least provide a more palatable experience for our patients. And maybe some instructions.


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