By Charles E. Crutchfield III, MD
Last week in this column we discussed how individuals and their families can help reduce healthcare disparities by developing and executing Personal Health Plans (PHPs). This week we look at other players who can contribute to this effort
For individuals without immediate family willing to participate, the community can help. Local community centers and other organizations like the YMCA and YWCA and even religious organizations and churches have done a great job in the past, and they should continue to develop and refine support programs to assist those in need to follow their PHPs.
These organizations can also assist in healthcare access by organizing transportation to eliminate barriers to getting to medical appointments. For organizations with available resources, they can also offer supportive nutritional and fitness programs. Organizations that have made similar commitments are already reaping dividends for their members and the community at-large.
Physicians and medical schools
Physicians and medical schools must continue to emphasize and develop better preventive care programs rather that the “repairative medicine” emphasized in the past. While most have done a fine job promoting preventive medicine, it’s time to promote the development of a formal PHP, in writing, for all patients to follow for good health.
The PHP should be in a format that is easily retrieved and reviewed. The medical community should develop a gentle and friendly monitoring system to assist patients in following their PHPs and to help overcome barriers that prevent patients from doing so. Government funding could be available to help defray the cost of these monitoring systems.
Finally, the PHP should contain an advance directive. These are instructions and what kind of medical care you would want to receive if you were unable to communicate. Some advanced directives also designate a person to make decisions for you if you are incapacitated. Physicians should make sure all PHPs contain an advanced directive. An inordinate amount of money is spent in the last year of life as a result of not having an advanced directive. This will go a long way in improving the quality of care for all.
Pharmaceutical companies can help narrow the disparity gap by offering medicines at reasonable prices. Nobody has even tried to defend why a pill costs five times more in the Unites States than the same pill costs in other countries.
As the government is the largest purchaser of prescription medicines, it should use that buying power to insist on discounts for volume purchases and pass that on to the consumer. For the same reason giant retailers like Walmart get the best volume pricing from supwpliers, the government should be paying the lowest possible retail prices for medicines. Any reduction in the cost of medicines directly reduces healthcare disparities.
Increasing access to physicians
And patients need access to their physician, which is becoming an increasing problem. While legislation alone cannot guarantee meaningful access to a person’s doctor of choice — a critical element to successfully maintained health — our elected officials have a growing impact on whether patients have that access.
Funding to attract doctors to underserved areas, funding for transportation for those in need to travel to or be visited by their doctor, and legislating access for the widest pool of physicians are immediate and direct means to reducing healthcare disparities and improving overall health.
Next week: How insurance companies, elected officials and the media can also help reduce health disparities.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.