Through blogs and comments, patients and experts explore what it takes to find good health care and make the most of it.

Are You a DIY Traveler/Patient?

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Once upon a time, most people traveling outside the US depended on a travel agent and some were only comfortable when they were part of an organized tour. Finding top hotels or out of the way adventures was best left to experts. Travel guides available at bookstores, though often outdated, were gripped in sweaty hands, consulted like Bibles.

Now I can plan a trip at the last minute, securing deals on flights and interesting places to stay. Does anyone still use a travel agent? And I am guided by virtually real-time reviews from fellow travelers rather than reports from someone who gets paid commissions by the industry or who visited the location months or even years ago.

I was reminded of this evolution to do-it-yourself (DIY) travel'when I heard several health care experts suggest at the Campaign for Better Care program this week that advocating for reimbursement and provision of professional care coordinators is their #1 priority' vitally critical for the success of health care reform outcomes.

Really?  If the rest of the marketplace can teach us anything it is that more and more services once provided by professionals are now in the hands of everyday folks. Online banking, brokering stocks, real estate financing, and yes, travel'.more and more of the detail work gathering options, weighing trade-offs and making choices has been embraced by consumers. Why, in a time of growing health care costs and complexities of diagnosis and treatment decisions - would adding a layer of paid professionals to navigate the system for us likely be a killer app?

While I applaud those who understand how difficult it is for patients and caregivers to organize many providers, medications, tests and treatment regimes, particularly for those with chronic condtions, I am skeptical that handing these tasks off to another busy professional is the best answer. Yes, there are undoubtedly some who will not be able to manage to pull all the pieces together. They are already ill; they are frail; they lack knowledge and skills, and they will need such help.

But I suspect this number is modest. Rather, it would be modest if providers and institutions and health plans made it possible for the vast majority of us to find and use good evidence and resources and guidance and real person reviews.

We have made the transition from laypeople dependent on experts to competent users of online information in other domains. And we have shown a remarkable ability to make use of the transparency afforded in other industries to make choices that satisfy us. The proposal to provide us with a health care nanny sends a signal that there is little need to participate in finding and making good use of our care. And it sends a message to clinicians, insurers, hospitals and laboratories that they are not accountable to us.

More Blog Posts by Dorothy Jeffress

author bio

Dorothy Jeffress, MBA, MSW, MA, (djeffress@cfah.org) executive director, joined CFAH in March 2008. Prior positions include vice president, Center for Information Therapy, 2005-2008, where she assisted with the IxAction Alliance membership program, the annual Ix Conference and finance/administration for the IxCenter; and as the assistant vice president of Value Based Purchasing for the National Business Coalition on Health (NBCH) from 2003 to 2005, where she directed the eValue8 Request for Information (RFI) program. She also worked with NCQA from 1999 to 2002 where she was the director of constituent relations and a senior health care analyst in HEDIS performance measure development. She has also worked for the Massachusetts Department of Public Health as the director of a CDC/state-funded women's health promotion and chronic disease prevention program. She has managed a TPA for self-funded employee benefit programs and also been a benefit manager for a mid-sized employer. Dorothy has an MBA from Clemson University and an MSW in clinical social work and an MA in theology from Boston College.


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