Sunday, June 28, 2009

Continuity Of care for patients

HMO and IPA ( Independent Physician Association) in California and Other states do not believe in pt's continuity of care and that results in poor quality of care being delivered to pt, high dissatisfaction rare and high readmission rate to hospital. I belong to two IPA,mainly,Greater Covina Medical group and Health care partners and both have hospitalists who take care of my patients in hospital.These hospitalist has no clues about my patients and they never communicate either during admission or discharge.Only goal of theirs is to maintain Length of stay and good average bed day .They do not spend enough time with my pts and pt come back from hospital and tell me how these so called hospitalist spend not more than 30 seconds per day and do not even spend time during discharge process. Most of my patients are so unhappy and I have informed IPA about it and told them that let me take care of my patients in hospital,nursninghome and home to make sure there is continuity of care and best of all, these are my patients and I know their problems well and there is trust and they will follow my advise. My request did not have any positive effect instead , they have now SNIFist and Nocturnist and Specialty Clinic Docs( same Hospitalist act as Specialty clinic Docs)...
HMO and IPA do not believe in taking care of patients best interest rather their bottomline.
They have been part of breaking the healthcare sytem in piecemeal and then trying to do patchworks and when it os not working out they come and blame PCPs.
IPA people like medical director will sit down with PCPs and show them number and say "well, these numbers do not look good,you need to take care of pts and keep them away from ER"
In a recent meeting I told them " If I donot have control in hospital care or discharge or any communicaiton with hospitalsit or SNIF care or home care,why should I be responsible" They were stunned with my response. I am still negotiating with them to let me take care of my patients from A-Z. I am hoping good sense will prevail in their heads .

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