We’re Not Doing Fine, Oklahoma!
By miller727@icloud.com December 17, 2016 Uncategorized 8 Comments
We are NOT doing fine, Oklahoma! Far from it.
In case you were not aware, Oklahoma is in the midst of a health crisis. I have confirmed this information by speaking with several random people here and there over the past few years.
If you doubt my evidence, take a few minutes to peruse Friday’s Tulsa World where you will find this article on the current state of health in our state. I’ll warn you in advance – it’s not a pretty picture.
Oklahoma ranks No. 46 in the United States for its poor health behaviors and outcomes, according to the United Health Foundation’s America’s Health Rankings report.
We are 45th in Health Behaviors, 37th in Community and Environment, 41st for Health Policy, 47th in Clinical Care, and 44th in Health Outcomes. Add that all together and you get … BAD!
This report details that because of these abysmal health rankings, thousands of our citizens are dying each year due to preventable diseases.
That’s like a Boeing 757 fully loaded with Oklahomans plummeting to the ground every month or two. You would think a disaster like this would get our attention, but it hasn’t. Our state has been ranked in the bottom ten of states for the past twenty years.
What is perplexing is that most of us are relatively happy with our own physicians and local hospitals. At the same time, we truly have no idea how terrible the health care system is for everyone else.
How the performance of our state physicians and medical facilities has escaped scrutiny for this long is criminal.
It is very clear from a cursory look at this report that Oklahoma doctors are not doing their jobs. Numbers don’t lie. Our state has ranked in the bottom ten in most health categories: obesity, diabetes, mental health, infant mortality, cardiovascular disease, cancer, and premature deaths for decades.
What are our physicians doing about this? Apparently very little!
Are they just lazy and uncaring, knowing that their union bosses at the American Medical Association (AMA) will protect them?
The real question is how much longer are we going to be satisfied with #46?
We need REAL health reform in Oklahoma . . . reform that serves us patients rather than the medical bureaucracy bent on maintaining the status quo. What we need is for our physicians and medical care facilities to submit themselves to measures of accountability.
Maybe, it is time that Oklahoma starts grading hospitals and medical facilities with something that would be transparent and easy for us to understand?
I got it–how about an A-F letter grade? If it works so well for public schools, it could work just as well for measuring health outcomes for doctors and medical facilities.
A single, summative medical A-F report card would ensure doctor accountability. Don’t you agree that parents and communities should know what medical offices are excelling and which ones need additional help?
And, we don’t want a bunch of data mumbo jumbo and complicated multi-syllable words – just one single letter grade will do it.
Physicians should be evaluated on such items as the yearly changes in the weight, blood pressure readings, and blood glucose levels of myself and fellow patients. They may earn bonus points if patients show up for all their check-ups. Physicians and health care facilities who cannot demonstrate consistent growth by these measures will be target or priority groups.
Not only can we track the health index of each citizen, but we can track their annual growth by subgroups. People in groups like “smokers,” “heavy drinkers,” “morbidly obese,” and “slugs” should obviously be expected to show greater growth than those in the healthy and fit subgroups. We can no longer subject these unhealthy people to the soft bigotry of low medical expectations.
Furthermore, we should require doctors to address the issue of chronic missed appointments. If 90% of their patients do not make their scheduled annual physical, we should, of course, blame the doctor. What are they doing to ensure their patients understand the value of a healthy lifestyle and routine medical care?
These new medical designations are not intended to punish our physicians and medical professionals, rather to bring their deficiencies to light through this fair and transparent process for the good of all Oklahoma health care consumers.
Once a year, these rankings would be published in the newspapers to provide enhanced accountability and transparency. Physicians and facilities designated as target or priority will be required to perform increasingly frequent weight checks, blood pressure screenings, and finger pricks. There will also be periodic pre-screenings to ensure patients are adequately prepared for their high-stakes screenings.
Of course, the standards for what is considered “healthy” are subject to change. For example, just because 120/80 was considered “normal” blood pressure in 2010, that does not necessarily translate to normal today. Therefore, if too many medical facilities earn an A or B on the system, we will reassess what healthy really means to ensure we have a bell curve of performance.
I mean, not all doctors can be competent, right? For every one “A” doctor, there needs to be an “F” doctor, too.
If physicians and health care facilities are unable to add value to indicators of health on a yearly basis, their personal and organizational evaluations will reflect this and patients will be given the option to transfer to higher-performing facilities. These facilities will be allowed to cherry pick the healthier patients and exclude anyone that is overweight or has poor health habits.
The doctors with the more unhealthy patients will likely have lower scores but that should make them work harder, right? I am sure good doctors would love this plan as it would point out their mediocre colleagues and maybe direct more incentive pay back to them.
While I’m on this topic, why haven’t we considered consolidation of medical facilities.
Why on earth do we need thousands of small medical offices spread across small communities in Oklahoma, each with their own high-priced doctor and admin staff. It would be much more efficient to have four or five Super Hospitals in the state run by just a few hospital administrators. The money saved to go to provide nurses with a long-overdue pay raise.
I suspect that some doctors will push back on the suggestion of greater accountability. They will try to make excuses and blame their patients for being overweight, having high blood pressure, being physical inactive, catching diseases, or smoking cigarettes. They are just passing the buck to avoid accountability. That’s what whiny doctors do.
The bottom line is the status quo is not working for many of our citizens. No one should be trapped with a bad doctor because of their zip code.
This commitment to transparency, accountability, and rigor will produce real health reform and ensure we do not lose another generation of Oklahoma patients to medical mediocrity.
We simply cannot continue to support public medicine under these conditions.
46th is not OK!