Blog | Friday, November 11, 2011

The health care rush during the holiday season


Like Christmas season advertising, the holiday crunch for procedural medicine is coming earlier every year.

Perhaps that's why the posting on this blog as suffered: we're busier than ever.

Why is this?

I suspect it's because of a variety of forces that are coming together to create the great procedural "perfect storm" this time of year.

Perhaps the most important contributor to the holiday rush is the patients themselves. Patients are feeling the effects of their higher health insurance costs like never before. Higher co-pays and annual deductible amounts are making them frantic to get their high-ticket procedures performed before year's end to avoid paying an even higher deductible amount next year.

Additionally, staff want to take vacation this time of year. This puts constraints on specialist's lab time availability. It's a supply-side bottleneck. To relieve the crunch, the same staff are finding themselves working longer and longer days already.

No doubt the government regulators and hospital administrators are enjoying the fruits of their regulatory victory. Seriously, how could it get better? More cases, same staff, lots of new "efficiencies."

Bada bing, bada boom!

But there's a catch. Maybe not now, but sometime soon. We've seen inklings of it. Nothing big in the grand scheme of things, mind you, but inklings nonetheless: workers are getting frayed. Since hospitals work to keep overhead costs low in anticipation of still more cuts to government payments, hiring has slowed. Burnout of existing staff is a real concern. Not just with doctors, but ancillary staff, too.

So far, our new health care system has been engineered to take care of lots and lots of patients. To this end, they are succeeding. But as this holiday crunch continues this year and beyond, the pop-off valve to our new health care delivery system pressure-cooker remains the doctors, nurses, and other ancillary personnel workers who work tirelessly to feed the beast.

Add to this the fact that our providers are increasingly regulated into forced behaviors without concern to the additional time that these regulations require. There seems to be more time spent on regulation requirements ("performance measures", and the like) in exchange for less time for patients and less time for home. As a result, all our direct providers of health care (nurses, doctors and ancillary staff) remain our new health care system's weakest and most vulnerable link.

And what happens when these worn out, burnt out, overbooked workers make an error as overstressed structures do?

We get more regulations.

This post by Westby Fisher, MD, appeared at Get Better Health, a network of popular health bloggers brought together by Val Jones, MD. Better Health's mission is to support and promote health care professional bloggers, provide insightful and trustworthy health commentary, and help to inform health policy makers about the provider point of view on health care reform, science, research and patient care.