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Improving Efficiency in Medical Care

The very principle behind emergent medical care is supposed to be expedited, readily available care at all times (because it’s not as if people only break their arms during working hours). And this is why it seems so innately perverse for an emergency room to have a waiting list. As the problem becomes self evident, it is imperative to do what we can to help.

In the hospitals in Savannah, there is a widely acknowledged lack of efficiency in patient care. This inefficiency is not only detrimental to patients, but also to the doctors. Most predominately in the Emergency Room, patients wait much longer than necessary and doctors are put under the steadily growing pressure of a long waiting list. To help expedite processes in the Emergency Room, where patients are presumably most in-need of expedited service, people should be made more aware of the illnesses which truly need emergent care. Many of the illnesses that lead a patient to the Emergency Room are, in fact, ones that do not require immediate care, such as a cold, the flu, etc. Because of these superfluous visits to the emergency room, those who are in actual need of the immediate care are postponed or delayed.

The idea of a long wait in the ER is intrinsically problematic. Those who seek care in an ER are, presumably, seeking the most immediate care possible and in the most dire of circumstances. This is important because the health of a community is arguably the primary object of concern in the sustainability of such community. If a person is sick, they can not go to work. If a person goes to the hospital and receives less than utmost attention and care, they may be excluded from the inner workings of society for longer than what is normal all due to their struggling health. A community can not thrive and grow if it is not also healthy and strong; and there is no better way to sustain a healthy and strong community than with the best hospitals and medical resources possible.

I hope to create a more efficient environment in the Emergency Room by way of various strategies. My strategies for patients include visiting a walk-in clinic and scheduling an appointment with a doctor. For the medical representatives and personnel, my strategies are providing universal healthcare, to expand the ER with space, materials, and employees, and to limit what can be treated in an ER. With the combination of strategies there is a wide variety of results, the best of which being when the patients schedule appointments and when the doctors provide universal healthcare. I evaluated the merits of each combination of strategies with a list of effects for each payoff, with every advantage worth positive one and each disadvantage being worth negative one. The first number in the pay off for each situation represents the value to the medical personnel and the second number represents the value to the patient.

Below is a matrix with an explanation behind the values that I assigned:

Visit Walk-in Clinic, Universal Health care (1,3)

  • Patient
    • saves money (+1)
    • Open 24/7(+1)
    • Don’t need health insurance (+1)
    • Expedited care, less wait than ER (+2)
    • Not for serious injuries (-1)
    • Different physicians (-1)
  • Medical Personnel
    • Physician’s salary subject to government (-1)
    • Less crowded ER (+1)
    • More appointments–> busier offices, more money (-1 and +1)
    • Free insurance (+1)
Schedule Appointment with doctor, Universal Health care(2,2)

  • Patient
    • Less expensive than ER w/ health insurance (+1)
    • Interferes w/ work (-1)
    • Save money on free insurance (+1)
    • Less clogged ER (+1)
  • Medical Personnel
    • Efficiently used ER and doctor’s work day (+2)
    • Lose money from gov. Supplied health care (-1)
    • Treat patients w/ better care (+1)
Visiting a walk-in Clinic, Expand ER supplies and staff (2,2) Schedule Appointment with doctor, Expand ER supplies and staff (-4,2)
Visiting a walk-in Clinic, Limit what can be treated in ER (0,1) Schedule Appointment with doctor, Expand ER supplies and staff(2,-1)

Ultimately, these are the assigned values to each situation:

  Visit Walk-in Clinic Schedule Appointment with doctor
Universal Health care (1,3) (2,2)
Expand ER supplies and staff (2,2) (-4,2)
Limit what can be treated in ER (0,1) (2,-1)

It is clear from these matrices that the most beneficial option for both groups would be government supplied, free health care combined with scheduled doctor’s appointments.

I interviewed my dad, a doctor at one of the hospitals in Savannah; I asked him what he thought would be the best option for improving medical care for the general public. Part of the reason for the inefficiency, he said in response, is those who are going into the ER for injuries that don’t necessitate emergent care. This is because the health insurance that they are receiving through the government only covers the costs of ER visits and does not cover the prices of a scheduled appointment to the ER. Not only is the ER in this situation more affordable, but it is also more practical for people who have strict working hours and can’t afford to miss work to fit the working hours of their doctor. He said “One problem is also that the cost of the care is often dissociated from the consumption of care because the patient may not have insurance and has no intention to pay or has an insurance like state run Medicaid and is therefore not responsible for the bill.” For other health insurances, such as the one his employees receive, there is a higher fee if they use the ER unless they are admitted, in this case the fee is small. He says that some people are using the Immediate Med or Doc in the Box (walk-in clinics) because they are open late and less expensive.

“Most people’s lives are so busy and complex and money is tight that we tend to put our health issues off until some perceived critical event.” In this case, such people wouldn’t have health insurance as a priority because, when budgeting, it is hard to spend money on insurance that is not immediately necessary.

This is one argument for universal health care with a single pay system, included in your taxes.  In Europe, they have easy access to medications and care because this idea is already implemented in their government policies.

  • Below is a map from an article in The Atlantic of all the countries in the world that have universal healthcare. The caption reads “Here’s a map of the countries that provide universal health care (America’s still not on it). The U.S. stands almost entirely alone among developed nations that lack universal health care.”

https://www.theatlantic.com/international/archive/2012/06/heres-a-map-of-the-countries-that-provide-universal-health-care-americas-still-not-on-it/259153/

My purpose in finding the solution to this problem is to raise awareness of both the issue and the solution. After evaluating potential strategies, I came to the conclusion that a combination of universally offered healthcare and scheduled doctor’s appointments when appropriate or possible would be the most mutually beneficial option. After reaching this conclusion, I want to promote it as much as possible in order to encourage the onset of both. The first step in solving this problem is ensuring that people of the community know where the issue lays and what they might do to improve their medical treatment.

In the future, there are many ways that you can contribute to help advocate for this solution. Whether in conversations with relatives at family reunions, staying in touch with politics and voting for the representatives who support this cause, or simply limiting your visits to the ER when possible, it all HELPS!! (Yay!)

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COMMENTS: 1
  1. April 30, 2017 by Mousa A

    What an interesting topic, thanks for bringing it to light! I will try to bring awareness to it as much as I can 🙂

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