Center for Improving Value in Health Care
Nov 18, 2015 | 0 comments | Posted by Global Administrator
Guest Blog by Matt Guy, Managing Director, Pueblo Trip Aim Corporation
I’m sure I’m not the only person to wind up in the emergency room asking this question. I definitely know I’m not the only person to start out with a minor health issue that turned into a major problem. How my health status moved from a minor to a major problem is a story of how the Triple Aim wasn’t well implemented in my life.
Among many other pursuits in my life, I am an official for USA Swimming. This means I spend a lot of weekends in the summer staring at the water, watching people swim. A side benefit of being a swim official is you get fed really well. Unfortunately at one of the last meets of the swim season this summer, some green chile and I had a disagreement, and the chile won.
I figured I got a small case of food poisoning, and in 24-48 hours, I’d be back to normal. This all started on a Saturday (of course), and by Sunday my condition had significantly worsened. I decided to go to urgent care, and was told I probably had an infection that needed treatment, but a lab sample was needed to confirm what bug I had and how it should be treated. I was to follow up with the lab sample and my primary care provider on Monday.
After dropping off the lab sample on Monday, I called my primary care provider’s office to get an appointment to see if I could get in and discuss treatment options as follow up to my urgent care visit. When I told the staff my conditions, they were very sympathetic, but told me the next available appointment was the following Tuesday. Not the next day, but a week away Tuesday. No appointments were available at all. They couldn’t even fit me in with a double booking, but they said they would call me back if anything opened up.
To say I was a bit frustrated was an understatement. What was I supposed to do? What I had didn’t seem worthy of a trip to the emergency room since I probably just needed an antibiotic, so I decided to wait and see if what I had would pass (insert your own pun here). I thought that if I waited it out, maybe my provider would get a cancellation.
By Thursday I was dehydrated, had lost nearly eight pounds, and was still feeling miserable. Despite even the best efforts of those who supervise and own the practice (who I contacted asking for advice and help), I still couldn’t get an appointment with my doctor. In spite of being promised I would get a call back, I never received a call from my provider’s office. I had to do something and although I didn’t want to incur higher costs myself and become a statistic – an “avoidable ER visit” – I felt my only choice at that point was to go to the emergency room.
My emergency room experience was tremendous. The providers and staff were fantastic. Within a short period of time they had me rehydrated (two liters of fluid), had lab results showing what bug I had, gave me a prescription for an antibiotic to fend off the bug, and sent me home. I was to follow up with my provider if I had any further problems. Fortunately, I didn’t need the follow-up.
The good news is that I recovered and am doing fine. However, the system as a whole failed me and provided a real life example of the importance of Triple Aim work. The cost for treatment in the ER was more expensive than it would have been in my doctor’s office; my overall health suffered for longer than it needed to (I don’t recommend this as a weight loss program); and my experience with primary care could certainly have been better. These are the situations Pueblo Triple Aim Corporation (PTAC) is working on with partners in Pueblo. The goal is to help the Pueblo community avoid situations like mine by focusing on the availability of excellent primary care, good health prevention programs, and emergency department diversions for non-emergent issues.
By the way, in case you’re wondering, green chile and I now have a much better relationship. That’s a must when you live in Pueblo!
About the Author: Matt Guy is the Managing Director of the Pueblo Triple Aim Corporation.
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