|
EDITOR'S
NOTE
|
|
February
18, 1999
There’s no escaping it: The only way the United States will control healthcare costs without implementing rationing is to allow nurses and allied health professionals to directly manage more chronic care. So far, we’ve tried tinkering with costs by limiting formularies, discouraging care by physician specialists, and moving people out of the hospital more quickly. Some of these decisions have been appropriate and some have been heart-wrenchingly wrong. But the emerging demographics of our society and the success of our pharmaceutical and surgical technologies are increasing the number of people who need skilled management of chronic health conditions. It’s an extraordinary opportunity for nurses, physical therapists, respiratory therapists, speech and occupational therapists, pharmacists, and dietitians to assume more direct responsibility for the care of individual patients who need professional help managing their symptoms and the side effects of treatment. The patient with COPD needs help assessing his tidal volume and treating the side effects of steroids. The senior who has just had a hip replaced needs help gradually increasing her mobility without compromising the success of the surgery. The post-heart attack baby boomer needs stress-reduction and lifestyle advice, and regular blood pressure monitoring. The patient with diabetes needs to check in about his blood sugar and fine-tune his diet and exercise plan. Most patients, once their conditions have been correctly diagnosed, can be well-managed by nurses and allied health professionals adept at chronic care. Patients should have quick access to physicians whenever there’s a change in condition or when an acute problem develops. But for the week-to-week or month-by-month management, most chronic care doesn’t require a physician’s expertise. A poll done last week by ICR (International Communications Research) of Media, Pa., for the Associated Press showed that more Americans feel they are losing personal control over health care. While nine out of 10 Americans said they were very satisfied or somewhat satisfied with their health insurance coverage, those in managed care plans have concerns with health insurance. Most are worried they may not get treatments that they some day may need. Three-fourths of those who said they were dissatisfied said insurers were the main cause of their frustration. But if the system were restructured to allow nurses and allied health professionals to practice to the full extent of their abilities, patients’ needs would be met more efficiently and directly by people who are geared toward chronic care. At the same time, less money would be wasted on unnecessarily expensive providers. It would be easier to get an appointment with a physician because he or she wouldn’t be spending as much time managing chronic care. And the money saved could pay for more expensive but necessary drugs and treatments. What will it take to lower healthcare costs while increasing access to care? The way I see it, there’s only one way to solve that equation. Let nurses and allied health professionals finally do what they have been educated to do. Barbara
Bronson Gray, MN, RN |
|
|
PREVIOUS Lose
it Alphabet
Soup If you are looking for rewards, try nursing Health reform and the election Honoring our profession Keep "alternative" in alternative therapy What is wrong with a healthy profit? How much education do RNs need? Nursing your image in the media
|
|
|
PREVIOUS Virtual
Viagra New
blood
Protecting
the Planet Burdens
of Care Diversity
& Healthcare Professionals |