Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Who coordinates patient care? Maybe no one.         

Bonnie Friedman
Patient
January 20, 2017
Share
Tweet
Share

“Who’s in charge of the case?” the doctor asked a bit impatiently.

My husband was in the hospital, and his care seemed disjointed and fragmented. I was concerned and called his primary care physician (PCP) to ask advice. He hadn’t known my husband was in the hospital again and seemed frustrated.

I thought about his question for a minute and answered, “I guess I am. I am the one who talks to all the players and puts all the pieces together.” After a moment of silence, the doctor began asking questions and offering insights. With his help, I considered next steps for my husband’s care.

The situation begs the question: Who is supposed to coordinate care? A Harris Poll released in late 2016 found that nearly 70 percent of seniors either rely on a family member to coordinate their health care or, worse, have no one at all to manage their care. The survey of 1,000 seniors — many of whom have serious health problems, more than one medical condition, and three or more health care providers — also revealed that 63 percent have no one to coordinate their care following hospitalization.

Gone are the good ol’ days when a primary care physician (PCP) would oversee all care, including a hospital stay. Now, a hospitalist, who doesn’t know the patient, has responsibility for care management, but only until the patient is discharged. It is assumed that the PCP, who may or may not have knowledge of the hospitalization, will pick up the pieces when the patient goes home.

Being sick is bad enough. Lack of coordinated care can make a bad situation worse, leading to misunderstandings, confusion, mistakes and more. Information can fall between the cracks, be overlooked or marginalized. Patient misunderstandings and medical mistakes can have serious consequences, even death.

Over the years, my husband has been hospitalized multiple times for serious, sometimes life-threatening, illnesses. I have no medical training but lots of experience working in bureaucracies, running interference and getting results. So I have become his de facto advocate, playing a key role working with doctors and nurses, participating in medical decision-making and coordinating his care.

Some say my husband is lucky to have me involved and instrumental in his care. And I suppose that’s true. But solving the problems of care coordination would go a long way toward helping all patients benefit from health care delivery.

While we are unlikely to see overnight solutions to the problems with coordination of care, some efforts are underway, such as assigning nurse navigators to help guide and advise patients. Originally created to help cancer patients, nurse navigators are now working with other patients in some limited settings. Results can be significant for the patient, the family, and the medical provider.

Here’s another proposal that I would like to advance: Require hospitalists or attending physicians to consult with PCP’s when patients are admitted to and discharged from hospitals, nursing homes or rehabilitation facilities. And, add to that a requirement that, upon discharge, medical records are shared immediately— within 24 hours—with the PCP as well.

True, there may be some obstacles to putting this arrangement into practice, and it may cost hospitals and other facilities a little time and money to implement. But strengthening coordination of care can improve patient outcomes, reduce readmission rates and save lives. Results like that should be well worth the investment.

Bonnie Friedman is the author of Hospital Warrior: How to Get the Best Care for Your Loved One.

Image credit: Shutterstock.com

ADVERTISEMENT

Prev

How health care could crash the U.S. economy

January 19, 2017 Kevin 22
…
Next

Solve the opioid crisis by empowering the doctor-patient relationship

January 20, 2017 Kevin 7
…

Tagged as: Hospital-Based Medicine

Post navigation

< Previous Post
How health care could crash the U.S. economy
Next Post >
Solve the opioid crisis by empowering the doctor-patient relationship

ADVERTISEMENT

More by Bonnie Friedman

  • The advocate’s sword stands polished and ready

    Bonnie Friedman
  • Medicare for all: a campaign promise, catchy bumper sticker, or viable program?

    Bonnie Friedman
  • What is one thing that separates good doctors from great ones?

    Bonnie Friedman

Related Posts

  • More physician responsibility for patient care

    Michael R. McGuire
  • The ultimate in patient empowerment: advance care planning

    Patricia McTiernan
  • Patient care is not a spectator sport

    Jim Sholler
  • Why health care fails to deliver better value in patient care

    Kristan Langdon, DNP and Timothy Lee, MPH
  • What Celine Dion can teach us about patient care

    Edward Leigh
  • A universal patient medical record

    Michael R. McGuire

More in Patient

  • AI’s role in streamlining colorectal cancer screening [PODCAST]

    The Podcast by KevinMD
  • There’s no one to drive your patient home

    Denise Reich
  • Dying is a selfish business

    Nancie Wiseman Attwater
  • A story of a good death

    Carol Ewig
  • We are warriors: doctors and patients

    Michele Luckenbaugh
  • Patient care is not a spectator sport

    Jim Sholler
  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 13 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Who coordinates patient care? Maybe no one.         
13 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...