The decision on who to interview regarding changes in the health care industry was an easy one and timed just perfectly. My boss and friend for many years will retire in May 2016. I instinctively knew she would be happy to share the many changes in healthcare and the impact these changes have had on her professional career.
Regina Slone has been practicing medicine for forty-one years. She is a Professor of Pediatrics, a Pediatric Infectious Disease Specialist and the Section Head of Pediatric Infectious Diseases at the University School of Medicine and Children’s Hospital. She has spent the majority of her professional career in this organization. Dr. Slone holds an academic position combining teaching, clinical care and research which is the position of a traditional academic professor in a medical school. She is involved in activities related to the Center for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP). She has been on the city’s top docs list for many years. With these credentials, one can imagine the vast number of changes she has seen and the impacts these changes have made to the healthcare delivery system.
During the past five years, she has seen increased bureaucracy at both at a medical school and hospital level. She feels the hospital functions more as a large business entity rather than a large clinical care organization. Growth, market share and competition continue to be the emphasis. We have become the leader of pediatrics and have a monopoly on the pediatric market. In fact, the SOM faculty doubled from 300 to 600 in an effort to keep wait times down and to compete in the private practice model. She believes Children’s Hospital has pushed too rapidly for growth without giving the organization the ability to adjust to this growth. In addition, national pressure to compare hospital performance lead to a substantial increase in quality and safety measures within health care. Measurements such as reporting health care associated infections, medical errors, falls, and pressure ulcers have all become important initiatives.
Applying technology to medicine, specifically electronic medical records (EMR), resulted in changes in documentation, physician order entry, and electronic prescribing. According to Sultz & Young,
As the various forms of medical technology become established in medical practice, traditional diagnostic decision mechanisms will rely more on assisted decision making for physicians through computer decision support. EHR systems, computerized physician order entry, and electronic prescribing have become the medical practice norm. (2013, pp. 232-233)
Dr. Slone feels streamlining medicine by utilizing EMR takes more time and causes more frustration than the informative note in the paper record.
Another change occurred with community providers also known as primary care providers (PCPs). The PCPs stopped taking care of their patients in the hospital because...