I am Not So Sure

I am Not So Sure How I Feel About Complete Care – Here’s Why

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The Complete Care Model (a.k.a. complete care) is the hottest thing in American medicine right now. From primary care offices to every specialty under the sun, medical providers are jumping on board the complete care train in larger numbers. As for me, I am not really sure how I feel about it.

I understand the premise behind complete care. Rather than a single healthcare provider – think doctor or nurse practitioner – being responsible for the entirety of a patient’s care, the patient relies on a healthcare team. Moreover, the team does not focus on a single condition or treatment. Collectively, the team treats the whole person.

I could see how complete care would work in a perfect world. But this world is far from perfect. My own experiences with it do not inspire a tremendous amount of confidence. Perhaps that will change at some point down the road.

The Right Hand Doesn’t Know the Left

I remember when the federal government first demanded that our healthcare system adopt electronic health records (EHRs). That was in the runup to the Affordable Care Act (ACT). In theory, switching to EHRs would make it easier for medical providers to treat patients. Records would be shared universally across a nationwide network so that a patient could get quality care no matter the time or place.

I have discovered that it doesn’t work that way. Even with EHRs now the norm, healthcare providers do not communicate. It is not just that the right hand doesn’t know what the left hand is doing; the right hand doesn’t even know the left hand exists.

Every time I see a new provider for the first time, I need to complete a full health profile. I need to reveal all the details of my medical history. The EHR system was supposed to eliminate that. But it hasn’t. How can I trust complete care if the different members of my team are not even capable of sharing records?

No One Answers the Phone

Another one of my frustrations with American medicine is an inability to actually talk to someone. Nobody answers the phone anymore. Instead, calling a healthcare facility means spending a ton of time navigating automated menus only to be transferred endlessly. When you finally do end up on the right line, you are put on hold to listen to cheesy elevator music until you’re finally disconnected.

Where I come from, that doesn’t look much like teamwork. Today’s healthcare system is a conglomeration of corporate interests that have bought up large swaths of the medical landscape only to separate healthcare delivery, scheduling, billing, etc. into separate departments that never cross paths.

A Noble Pursuit

KindlyMD.com is a QMP group operating in Utah. Complete care is part of their business model. I appreciate the fact that the group consists of multiple clinics staffed by a variety of healthcare providers offering services ranging from medication management to mental health. Their pursuit of complete care is a noble one.

I have no doubt they can make it work on a small scale. But if the group is ever bought out by a larger regional or state entity, their ability to offer complete care might be compromised. Let’s hope it never happens.

I fully understand the idea behind complete care. On paper, it looks like a good deal. I am just not sure it’s a practical reality under the current corporate healthcare system. Maybe we could make it work if we knocked the whole thing down and started over again. But the chances of that happening are slim to none.

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