Tag Archives: hospital care

Continuity of Care the Cure for Health Care Crisis!

The article in the NYT’s Blog post “After Caregiving, Comfort in having helped” tells a common and I believe already well told story.  Senior Care, cargiving, dementia Care, Assisted Living and health care in general is difficult, expensive and getting worse every day.  AGREED!

by Judith Graham.

Lets move on to the answer!!

CONTINUITY OF CARE IS THE CURE TO THE INDIVIDUAL AND GLOBAL HEALTH CARE CRISIS WE ALL FACE.

After Caregiving, Comfort in Having Helped

  • Value people and they will provide many in-kind servcies and levels of compassion and effort you cant buy for dollars.
  • Value your doctor, your family, your friends and their extended soical systema and they will value and help you when you and yours needs it.
  • this cant be legislated but legislation can adjsut the playing field.  We have to act, we the people need to value continuity of care and our doctors.  Many do not know that all doctors get paid the same for an office visit.   Your doctor who knows you, does extra inkind service gets the same as the guy who you dont know who says call anohter specialist.  Second, did you know that specialists get paid much more than your doctor but specialists often say I can’t decide on treatment, accept responsiblity for you as a person, that is your doctors job.  Seems unfair to me.  paid less as pcp but expected to do socially the right thing.  I assue you doctors have feelings too.  It is less about the money and more about the value people plance or give to their doctor.
  • Senior Care settings, Assisted Living, Residential Care homes, hospitals  also delegate care.  I for one would be suspect of a place that says I want you to come but the people who work here are not my responsiblity.
  • Do not criticise the current system.  We all have allowed and fueled its growth.  The cure is still right here.  We need to value each other, people, our extended social systems to fix a problem that affects all today indirectly by affecting someone in our own extended social system right now and us tomorrow after an accident or expeceted medical issue, and 5-10 yrs from now when we age ourselves.
  • did you know we all get medicare!!  Yep, if you get hurt right now you get medicare disability.  There is so much you dont know and I cant do it all in one post.  If you invest in me, send comments, I can invest in continuing the discussion.

I am sure that the only way to fix the health care system, make it cost effective while still providing a high level of care is to value continuity of care.  Let me know what you think.

Help us spread the word.  Click for Free Ways to help.

Dr Shawn McGivney

 

What is a Case Manager?

What is a Case Manager?

Our first task is to help all of us define what a case manager is? We need all to comment on what they think a case manager is. Then we will summarize how we define it. We want to make this an interactive learning process so please comment!!

Sample things to consider?
What type of “case managers” have you heardof? What settings have you heard that term used?
What special licensing have you heard associated with “case managers”
Separate from licensing what actual skills do you think a case manager needs?
What does or could a case manager do for you?

Doctor, or  Nurse, Or Social Worker, Or Hospital employee, or…

There is no job, or single training the clearly is better than any other   What you need is a high amount of training and active practice in all of the above areas in all care settings, hospital, rehab out patient and the many types of inpatient rehab, Assisted Care settings, Home Care, Private Case management, all of the allied care settings, cosmetic and less medical but widely used and needed care, emotional health out patient and inpatient, and many others.  Add in specialization in chronic illness and Geriatrics.  Needless to say few people have that training.  I consider myself fortunate to have most of those care experiences.  While most nurses are not doctors I have done a lot of direct nursing care and care giving while caring for my own parents.  I do hands on care with residents all the time.  I have had patients say don’t help me with that you are the Doctor. In the end every one is a doctor and every one is a patient, like patch Adams says we all help each other doing what we can, even listening is a job.

 

Case manager is a term with no definition, no expectations, since we know of know standard for that term.

Many will claim to be case managers.  There are two main kinds.  Those that manage your case but work for the hospital ,  institution, Assisted Living Facility, Home Care, Hospice Care businesses and those that you pay with your private dollars.  Of course, I am very biased as a Geriatric Specialist who has worked in all long term care settings, has worked in private case management not as the person who asked the doctor what to do but as the doctor who knows what is needed and what is cost effective.  My view is very biased.  Indeed, I recall many times when a private pay case manager called me and suggested something that had no medical benefit.  I did see the benefit to her in that she most likely needed to show her clients she was worth the $250 per hour she was being paid.  Needless to say I did not feel her comments were needed.  I do also have to say that case managers often times do know more about private pay home care and many outpatient services that most doctors have never heard of and if that is the comparison then they can help.  Either Case manager or Doctor Case manager if the person does not do some direct care, spend physical time with the senior, their family and the care giver staff the benefit of their knowledge and skills are reduced significantly.  Continuity of Care is good Care, the Best Care.

 

The golden rule applies again.  Meet the entire care team you are getting from the top management, the doctor, administrator, middle skill people the nurses and other professionals and then the caregivers.  The people provide the care.  You need a doctor or team leader who knows the patient but also all of the staff since continuity of care requires a team approach.  That is a team approach in practice and not only on paper.

By Shawn McGivney MD, RFA

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Contact:

Shawn McGivney MD, RFA

Shawn@tlcsr.com

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