Patients are wary, if not downright distrustful, of the healthcare system. The disdain is fueled by inflated patient expectations, fear of managed-care manipulation and confusion about how to cope with an increasingly complex medical maze.
Managed-care organizations have done a decent job managing healthcare costs but-at least until recently-a lousy job managing care. Providers, meanwhile, are caught in the frustrating dilemma of balancing patient needs with contractual realities. In too many cases, providers have become middlemen between patients and payers. The system isn't designed to function that way.
How bad is it?
In public opinion polls, managed-care administrators seem to rank somewhere between tobacco executives and used-car salesman on the list of admired professions. Moreover, intensive research by the American Hospital Association, the Picker Institute and Yankelovich Partners indicates profound image problems with the healthcare system. Many patients say they don't receive enough explanation about their medical treatment and aren't shown proper respect by caregivers. A majority complain about costs and quality.
Meanwhile, the media continue to pursue complaints that medical care is withheld for financial reasons. Whenever a story appears in print or on the air, politicians and lawyers pay especially close attention.
Healthcare managers must mount a major, spirited effort to improve the situation. First, managed-care plans must do a better job educating patients about how to use the system and clearly outline details on treatment limitations, including ways to appeal coverage denials. Second, hospital administrators should work with caregivers to ensure a smoother transition between inpatient and outpatient care. Finally, physicians, nurses and staff must commit to better communication and emotional support for their patients.
Delivery fragmentation, medical specialization and managing the cost of care are the hallmarks of today's healthcare system. Certainly higher targets must be hit if providers are to retain the support of their customers.