Physical therapist John Duffy has to pick up the pieces when care is delivered poorly elsewhere:

One of my new patients yesterday had gone to, let’s say an “alternative” healthcare provider, for her asthma, at the recommendation of a friend. After telling this person she did not want her neck adjusted or manipulated, it was done anyway. So, of course she still has asthma, and now she has neck pain and a damaged nerve root causing arm weakness. It brings up some interesting questions:
1. How is it that certain aspects of healthcare are allowed to say they can do things, yet they have absolutely no proof ? Giant Eagle can’t sell horsemeat and say it’s beef, BestBuy can’t tell me the LCD television is LED…so why can these people tell the public they can do things that have no evidence to back it up?
2. Implied consent gets tossed out the window once a person notes they don’t want a certain treatment….yet this seems to happen over and over….people getting their necks adjusted even after saying they decline that treatment. My sister will attest to that.
3. Why aren’t people taking more time to research this stuff on their own? I’ll read Amazon customer reviews for a garden hose nozzle to make sure it’s OK before purchase, yet people will blindly go get a treatment they never researched, or from someone they’ve never checked into.
Done ranting.

Medicine as a business has its own set of realities, rules, and logic, totally different from any other business.  Providers of health care should be paid based on the quality of care they deliver, which should be measured in terms of clinical outcomes and patient satisfaction with that care.  The reality is that so many consumers of health care seek only one thing: convenience.  And so many huge, corporate giants are more than willing to jump into the act.  Why?  Money.  Big money.  What else explains the proliferation of urgicare centers, often run by or subsidized by insurance companies and hospitals, on every corner and in every pharmacy.  UPMC has their own “doc-in-the-boxes”; St. Clair Hospital has one on the way; Children’s Hospital has them; Highmark partly owns MedExpress.  Between my two offices (in McMurray and Bridgeville, 10 miles apart), there are four MedExpresses, one UPMC urgent care, one St. Clair Hospital urgent care center, one (large) St. Clair Hospital emergency department, one CHP urgent care facility, one stand-alone urgicare (Medi-Help), and several in-pharmacy walk-in clinics (CVS, Walgreens, Giant Eagle, etc).  Are people really that sick?

Within this 10 mile corridor, there are plenty of primary care practices to care for adults and children when they get sick.  Our Pediatric Alliance offices have tried to improve access for patients by having hours on Saturday and Sunday mornings and evening hours.  Shortly, we will begin walk-in hours each morning for acute care visits.  We strive to create a warm and caring “medical home” for your children.  We do our best to provide the highest quality care (best outcomes, satisfied patients and parents), and we continue to try our best to make that high quality care as convenient as we possibly can.  Still, it truly amazes me that, in just the last five years, I see that parents now would prefer to go to a doc-in-the-box — a place that doesn’t have their child’s medical history; doesn’t know them or their child; doesn’t have a physician (or, more likely, a nurse practitioner or physician’s assistant) who specializes in pediatric care; and doesn’t bother (in fact, refuses) to communicate with the patient’s medical home with a phone call or a fax — rather than rely on and trust their child’s medical home.   Rolling the dice on their child’s medical needs on a stranger’s care that is sometimes good, but often inappropriate or simply bad, parents may get the convenient service they desire. And pediatricians like me (and physical therapists like Duffy) will continue to pick up the pieces when things don’t go right.

Done ranting (for now).