The Future of Healthcare

September 7, 2016

 

Health care is changing.  And it’s changing at a rapid pace.   While we here in rural, small town Ohio may not see the forefront of change coming when we show up at our local doctors office and all of the décor still remains the same, I can promise you, that change is coming.   On the verge of an ever heated political election, Democrat, Republican or undecided, the political climate and decisions that are made impact us tremendously in regards to health care insurance, the type of treatment and care when it comes to physical illness and the type and care of treatment we get when it comes to mental illness.   Hm.  Interesting.   I just listed the type and care of treatment we get when it comes to physical and mental illness separate.  Why would I do such a thing?   Take a moment.   When we consider the type of treatment we go to our physician to receive for high blood pressure, does our physician take stock that our bills are running past due, that you’re working as much over time as you can, and the heated relationship between you and your family has escalated over the past few years.  All of which are likely contributing to your high blood pressure.  Unlikely. 

 

While I am not at all blaming your physician for not taking stock of the social and environmental factors that are plaguing your everyday life, your physician is likely under the same restraints.   Decreased reimbursement rates have pushed physicians to see more patients in an hour but to still provide the same positive outcomes in their patient’s heath.   Don’t forget to stay up to date on current technology or pay a big penalty for your practice in to Medicare.   Oh and did I mention that you’re getting graded on what your patient goes home and chooses to do with their own behavior that might affect the medication you just prescribed.   What I’m saying is, we are ALL dealing with a lot of things that the other party does not know about.   How would a physician have time to delve into all the stresses your experiencing?  Patients often complain “Well my doctor doesn’t listen to me.”   While physicians are often complaining, “But my patients don’t listen to me.”  

 

Here in lies the problem:  How does each party even have the time in today’s day and age.  But, we are on the verge of climate change in health care.   We have to believe that the mind and body operate together and have the power to create or heal both our physical and mental health.  How can our health care system help us with this?  My suggestions: By viewing us as whole people.   The definition of integrated health care as defined by the Substance Abuse and Mental Health Services Administration is “the systematic coordination of general and behavioral healthcare. Integrating mental health, substance abuse, and primary care services produces the best outcomes and proves the most effective approach to caring for people with multiple healthcare needs.” 1 in 5 people in America have a mental health or addiction concern.   1 in 5.   Look around you – are there four more people.   That means 1 of you could benefit from the improved services of integrating your health care.

 

How nice would it be to have a health care “one stop shop?”   Where after you meet with your physician a behavioral health care provider popped in and said, “Hey, is there anything I can help you out with today?”  Stressed at work?  Stressed at home?  Feeling overwhelming, suffocating anxiety?  Can’t get out of bed and barely made it to your appointment today?  Getting sick of your alcohol addiction and its difficulty in managing your hypertension. Yes is that you?  Let’s talk about that.  How would having a behavioral health care provider in your life on a regular basis, improve your health outcomes? Not to mention if it was covered by your insurance!

 

When your providers all work on the same team and can provide comprehensive care, they can better serve your needs and can better understand underlying complications and barriers to your health.  In integrated care, the goal is to never use the term “referral.”  How many times have you rolled your eyes when your physician has told you “I’m going to refer you to our . . . . .(insert eye roll here).”   In integrated health care, your mental health specialist would be down the hall, and would come spend 15 minutes with you at your visit that you are already in the office for.  Now the notion of this in our community, is not all that novel, due to many of our primary care physicians being force to prescribed anti-depressants and anti-anxiety medications due to the limited amount of psychiatrist in our area.   However, combination therapy (the use of prescription medication and talk therapy) is the hallmark of effective treatment.  This would put a mental health worker at your fingertips.  This gives your physician and your mental health provider a chance to work together on collaborating on your care more effectively.  Consider this: 64% of people who attempt suicide visit a doctor in the month before their attempt, and 38% in the week before.  What could have been done for these individuals if a mental health care worker had stuck their head in to this visit?   Now granted I am realistic enough to know that not all of these encounters could have been preventable but what percentage of this population could have received alternative, effective services.  Also, 68% of individuals with a mental illness have one or more chronic conditions.   Whose office are they visiting more often? Their mental health care provider or their physician?  In a study completed by SAMSHA, of only 170 enrolled participants there was as cost savings of over 2.5 million dollars.  Let me repeat 2.5 million dollars in health care cost savings.  Of these 170 enrolled participants, they spent 86 fewer nights homeless, had 50 fewer hospitalizations for mental health reasons, spent 17 fewer nights in detox, and had 17 fewer ER visits.  Per only 170 enrolled patients.   How is that not undeniable evidence for effective healthcare?

 

When we begin to incorporate mental health checks into our daily primary care visits, it becomes the new normal.   Some individuals balk at the questions of “Have you felt depressed since your last visit?” “Have you felt anxious or keyed up?”  But when we begin to incorporate behavioral health care vitals into our daily practice, it seems just as expected as getting your blood pressure taken and your respirations.   In fact incorporating behavioral health care vitals also helps to target mental health stigma.   When we begin to treat mental health the same as our physical health, only then can we get mental health care out into the open and discuss it, remove shame, and move forward with treatment.  (More on that later).  

 

Other countries often scoff at America’s “health care system.” They often don’t even refer to it as a health care system.   Some companies have even capitalized off of our “health care system.”  The fact that we take care of our families and friends and workers, not until they become sick, defines that we actually have a “sick care system.”  Integration aims to help reduce the sick care cost we incur by waiting too late for treatment.   By early identification.   By addressing barriers to treatment.   By creating a new normal where we look at individuals as a whole, we can treat individuals when they are healthy, and keep them that way.   Integration works.  It improves lives.  It saves lives. And it reduces health care costs. For more information on integrated health care, please visit http://www.integration.samhsa.gov/.   Visit this link for some great info and easy references to some alarming numbers: http://www.integration.samhsa.gov/Integration_Infographic_8_5x30_final.pdf

 

 

To pick my brain more about our health care system, email me at angiecastle.renew@gmail.com or give us a call to set up a business consultation appointment to help your health care practice move to the forefront of comprehensive care.

 

   

 

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