Conventional wisdom breaks the healthcare system into two big silos.
There’s acute-care hospitals, which tend the acutely ill, and there’s primary care providers, which handle the sniffles, hives, chronic disease management and anything else that isn’t likely to kill a patient within a few hours. In between, there’s a big black hole where patients pretty much sit around feeling like hell and wondering just how much worse things are going to get.
This bifurcation is absolutely insane and has got to end. It makes an assumption which is absolutely counterintuitive–in fact, which is simply crazy–which is that hospitals have no business treating anyone who isn’t at death’s door. The nextHospital has to completely shatter this assumption by providing appropriate care, from throat cultures to the crash cart, for anyone who shows up at its door.
Not only is the only sane, humane and appropriate way to treat the human beings who enter your doors, it’s the cheapest way to treat those who don’t need intensive services; after all, an all-night walk in clinic is almost 50 percent cheaper than ED care! Kinda sounds like a good idea, doesn’t it?
What makes hospitals’ failure to offer step down care even more foolsh is that all they’d have to do is invite Walgreens or CVS to bring in one of their TakeCare or MinuteClinics, which I’m pretty darned sure they’d be happy to do. No fuss, no muss, virtually no overhead. Everyone wins. Explain to me why this isn’t a good idea?
The current system assumes that if the healthcare system is falling apart, it’s all the fault of nughty patients who come to an emergency department and somehow don’t know that they aren’t that sick after all. Remember, the learned papers that castigate patients who show up in the ED and somehow fail to need lifesaving treatment aren’t any kinder to those who simply overestimated their acuity than those who use the ED as a primary care center.
Now, I’m not suggesting that primary care physicians shouldn’t exist, and that hospitals should take over their place in the community. But I am suggesting that hospitals accept their role as caring for people, not emergencies, and govern themselves accordingly. It’s more efficient, it’s more effective, and it’s more appropriate. Anything else just wastes time and money, while scaring away patients who need your help.