West Side Family Health Care Clinic will continue to grow in services as our construction project moves to operations in the fall of this year. We continue to offer appointments and walk-in services 88 hours a week. We are also becoming more proactive in promoting “Wellness” through Primary Care.
What is wellness? Surprisingly, that is not easy for me to define even though I’ve been in the health care business almost 60 years! The health care industry and most of the providers involved have, until recently, really focused on illness (treat or prevent) or injury (fix or repair).
In the past, chronic illness (aches and pains, life-style choices and aging) just didn’t seem to get a lot of attention until they became and illness or an injury. Mental health, now discussed as Behavioral Health, did not get a lot of high-level attention unless you, the family, or, a famous personality was personally affected. Why is that? Well, “follow the money”! That’s where the health care dollar is spent and that is what health insurance has paid for.
The “follow the money” path has been changing over the past decade, somewhat slowly to start but picking up momentum now. The focus on reducing costs in health care is changing from controlling or managing utilization to preventing or delaying use of health care resources. This change is occurring by encouraging providers and their patients to focus on improving the current status of a person’s health. This patient care “wellness” focus may be best described as Primary Care. What is Primary Care? Let me check “Google”:
Noun: Healthcare at a basic rather than specialized level for people making an initial approach to a doctor or nurse for treatment.
That sounds simple doesn’t’ it? But borrowed from several professional organizations such as the Institute of Medicine (IOM) on the Internet:
- The care provided by certain clinicians—some proposed legislation, for example, lists the medical specialties of primary care as family medicine, general internal medicine, general pediatrics, and obstetrics and gynecology. Some experts and groups have included nurse practitioners and physician assistants (OTA, 1986; Pew Health Professions Commission, 1994);
- A set of attributes, as in the 1978 IOM definition—care that is accessible, comprehensive, coordinated, continuous, and accountable—or as defined by Starfield (1992)—care that is characterized by first contact, accessibility, longitudinality, and comprehensiveness;
- A strategy for organizing the health care system as a whole—such as community-oriented primary care, which gives priority to and allocates resources to community-based health care and places less emphasis on hospital-based, technology-intensive, acute-care medicine (IOM, 1984).
Can we really make a difference with Primary Care unless we change the financial incentives and priorities that face physicians and primary care providers (see above “certain clinicians”)? That appears to be changing as the government (Federal and State) and private insurance payers have begun the Pay for Performance (PFP) system for providers of care. Some examples of the PFP measures are: annual physicals, vaccines for children, women’s health screening(s), blood pressure checks, non-smoking counseling are several among many measurements. Providers will be paid less if these activities are not done or documented, or, they will be fully paid or paid an incentive pay if patients are encouraged and the care is completed and documented.
Does that sound like an opportunity for providers to do more for patients and therefore health care will cost more? Well those who pay for health care don’t think so. The strategy is:
With financial incentives providers will be diligent in caring for their “whole” patient;
Patients will follow their provider’s advice and instructions (maybe even change life-styles if needed);
There will be fewer visits to providers, emergency rooms and admissions to hospitals.
There will be a longer, healthier and more active life style for all of us.
The Mission of the West Side Health Care District, your District, and West Side Family Health Care is “…meeting the challenges of the future by preserving quality health services for the needs of the Westside community we service.” We are meeting that mission objective by growing our space and services. We are also changing our focus to provide the benefits of Primary Care (Wellness) to our patients. We will continue to offer the walk-in services that all of us, on occasion will need.