Can we make health care more efficient?

As I put this column together I must begin with a confession. I have no training in the health care profession. My education is varied...and much of my income through the years has come from teaching art in public schools and at universities. It is totally fair that my ideas might be questioned. However; through observation and experiences as a patient, I have some thoughts regarding health care.

Prior to moving to Nova Scotia, I lived in Wisconsin. I resided in Neenah, Wisconsin for a number of years. While there my medical needs were tended to by a clinic in that community. Within that clinic there were General Practitioners, Internal Medicine specialists, Surgeons, a couple of Pediatricians, along with a number of other specialties. There were also Nurse Practitioners and Nurses.

If someone came into the clinic with a cold or influenza they would be seen by the Nurse Practitioner who assessed the patient. In most cases care information would be given, and possibly prescriptions would be written. If there were injuries an RN or Nurse Practitioner would clean wounds and maybe apply a butterfly bandage. If booster shots or needles of any kind were necessary, the RN or Nurse Practitioner would be first in line to take care of that need.

Basic prescriptions were most often renewed by the Nurse Practitioner or an RN...usually requested via a phone call. If there seemed to be a need for an extension of a one-time prescription (such as antibiotics) an appointment would be made. If stitches were needed that procedure would be done in the clinic by a physician in the clinic. I had a minor surgical procedure done at the clinic. Emergency care at the local hospital was for emergencies only.

I had my personal doctor...but if I had an issue that needed a specialist I would be given a direct appointment to the specialist. I did not have to make an appointment with my physician for a referral. At one point I had a problem with an eye, so I went directly to an ophthalmologist. This very quick, direct appointment saved sight in that eye. There would be times when my doctor felt it wise to get an opinion from specialist...resulting in a referral.

Our medical records were available to all physicians within the clinic...and the clinic had direct access to information held at the local hospital. The results from any blood tests, X-rays, or information related to any emergency room visits went into our medical files. When my son had an emergency visit related to asthma problems his Pediatrician had the information by the next day. This information allowed for changes in treatment.

In addition to saving time for physicians and patients, there is a health cost benefit...less duplication. Three years prior to moving here my son had an open wound from a fall. A trip to the clinic resulted a butterfly bandage. The cost of the visit was $36, which was paid by insurance. After moving here...and prior to permanent status...my daughter injured herself in almost the same way. We first saw the doctor in the office, and then had to make a trip to the hospital to get her butterfly bandage. The total cost, out of pocket, was over $200. This was 30 years ago so today that cost would be greater. We seldom see the actual cost of treatment. Hospital care is expensive.

I wonder if a clinic could be developed here...possibly under one roof. If not, there might be a central phone service serving a number of physician's offices. People would first attempt to contact their family physician but if their health need could be taken care of by a Nurse Practitioner...or might best be taken care of by a specialist...they could be sent in that direction. Paper medical files could be held in one place...but possibly pertinent patient information might be made available to any clinic physician via a computer file. Much of this information likely is already available to some in the medical field but could be more widely accessible.

There are many instances when a visit with an RN or Nurse Practitioner could take care of health issues. This would free up the physician's time and allow for more timely appointments related to serious situations. It could also ease pressure on physicians and allow for much needed time-off. Doctors also need to take care of their physical health.

Shirley Hallee is a freelance writer living in Amherst. Her column appears weekly in the Amherst News.