Consultant Describes Rocky Road Through the Health System

Paul Keckley, executive director at the Deloitte Center for Health Solutions, recently underwent knee surgery and things have not gone so well on the treatment and payment sides.

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Comments (3)
Very interesting story. I have been in the medical records field since 1996 and see similar rocky road stories. If I am sending records to providers, rather PCP's, SCP's or hospitals who is on the receiving end? In the early 90's I was a caregiver for 6 years to a cancer patient (my late husband)and back then they just did repeated blood work.
Posted by ALLISON A | Monday, January 30 2012 at 1:38PM ET
I am a practicing physician since 1885 in the USA initially in KY then VA and now in FL. I have seen a steady deterioration of Health Care system since 1991. I have made exactly the same number figure as my gross income in 1986 as in 2010 and this means that my purchasing power is about 1/8th of that in 1985. I do not know what specialty is making more money, but neurology certainly does not. We have not more paperwork: 10 pages for a scooter for my MS patient is routine. Denials are routine.
Medication denials by Caremark and Medco are routine. We spend hours on the phone ( unpaid ) to get our patients medications. They made electronic prescription mandatory and we cannot prescribe pain medication via electronic means because the government (state and federal) does not allow it. Why then electronic. About 40% of medications has to be printed on special paper which is expensive.
Practice costs are at all time high. Stress level increased and the legal system is not reformed. Physicians who are gaming the system are not held responsible but those who practice with care and ethics are at disadvantage.
Emergency room and hospital prices are outrageous and medication coasts are appalling.
I also experienced the "other side" I had a stent placed in my heart, the ER doctor wanted to send me home because I was judged anxious. I was not. I had to call my primary care who called a cardiologist and then a cardiac cath showed 90% obstruction of LAD. I spent 23 hours in the hospital about $25,000.00 The physical got paid about four hundred. Seems like doctors are overpaid.

I don't think you can fix this. The whole system needs dismantled and a new designed. The current system is inefficient, patients receive no care.The providers are becoming businessman, bureaucrats and technicians.

Leslie Huszar MD
Neurologist, Neurophysiologist
Posted by lhuszar | Tuesday, January 31 2012 at 12:11AM ET
This story is typical of where we are in US Healthcare and why EMR/EHR, and HIE are absolutely needed. Glad Obama/Congress presented HITECH. Much more progress is being made.

However, to deeply reduce healthcare costs we need to agressively implement the ideas presented in the book The Inovator's Prescription. That book is several years since publication. There are so many innovative ideas and a thorough history of how we got where we are. It is disappointing that with a documented pathway presented in this publication that we are not further along in reducing costs and improving patient outcomes simultaneously.

I am sorry for what you are dealing with in your health crisis. Although your say "My circumstance is relatively minor compared to others facing vexing health problems or caring for others" it is certainly personnally frightening wondering how this will play out in your future ability to walk etc. I pray you have a good outcome.
Posted by Gail B | Friday, February 03 2012 at 9:45AM ET
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