Dog wardens to canvass Luzerne county

web1_Wilkes-Barre-City-Police.jpg

Tossed cigarette leads to car chase, crash and foot pursuit

<p><em>Editor&#8217;s Note: Justin Matus serves on the board of directors of Commonwealth Health-owned Wilkes-Barre General Hospital, a competitor of the Geisinger system. </em></p><p>&#8226;</p><p>Geisinger Health System recently announced with great fanfare a form of money-back guarantee to its patients. While on the surface this may seem to be a wonderful policy, it is in fact a questionable idea. The refund policy suggests that purchasing health care is similar to purchasing a Big Mac, and like the Big Mac that is not to our liking, it suggests we can simplify the purchase of health care.</p><p>First, as a practical matter, any patient with health insurance should be very careful they do not inadvertently commit insurance fraud by asking for a refund after they have filed a claim. Perhaps more importantly, this idea sends a very wrong message to both patients and health-care providers. The idea that the quality of care one receives can be quickly and objectively measured by a patient is rather na&#239;ve. It makes trivial the concept of quality care. And it hints that enough patient complaints might be able to correct problems with our health care system.</p><p>Quite often, following a diagnosis, several rounds of assessment and treatment are done in a deliberate and progressive fashion. Doctors routinely pursue the most conservative treatment first, for a variety of very sound reasons, including avoiding unnecessary risk to the patient. Who among us hasn&#8217;t required a second or third visit to a physician to finally get a problem resolved? Were the first and second visits somehow inferior? Or was the physician doing his job and following the pledge to &#8220;first do no harm?&#8221; Moreover, not every patient responds to a given treatment in an identical fashion. Some patients respond more quickly, some more slowly, or sometimes unfortunately respond in an unfavorable way, such as with an allergic reaction, none of which can be easily forecast by even the most skilled health-care provider.</p><p>This policy potentially creates a destructive wedge between patient and provider, when what is needed is a strengthening of that relationship. Medicine is rarely a binary world of right and wrong with clear-cut solutions to clear-cut problems. More often than not, the most successful outcomes are the result of a collaboration of effort between the patient, the patient&#8217;s family and a team of health care professionals, including doctors, nurses and a variety of clinical specialists.</p><p>Health care providers operate in an extremely unique and unforgiving environment when even the most simple and routine task can turn at a moment&#8217;s notice into a life-and-death scenario; an extra zero entered on a medication order or a misfiled lab result can easily cost a patient his life. Patients expect and deserve quality treatment. However, in the current one-sided conversation about patient&#8217;s rights, we are ignoring the patient&#8217;s responsibility. Patients&#8217; failure to follow a physicians&#8217; orders is well-documented: Patients routinely fail to fill prescriptions, complete a course of medication or return for a very necessary follow-up appointment, only to be seen at the emergency room days or weeks later as a direct result of their own neglect. The extraordinary cost of such behavior is well known.</p><p>If we truly wish to engage our patients in a meaningful dialogue about the quality of their health and the quality of the care they receive, we need to do so in an open and honest fashion. Much of our individual health is in our own immediate control. Diet and exercise are among the most basic and impactful variables any patient can control without any outside intervention. The single greatest threat to our country&#8217;s health is the alarming rate of obesity. Childhood diabetes is on the rise with no improvement in sight. Prescription drug abuse, opioid and heroin addiction are further drags on our health care system.</p><p>Finally, we truly need a national dialogue about patient expectations, not only as it relates to our day-to-day engagement with the health-care system, but especially as it relates to end-of-life decisions and the consumption of scarce health care resources. There is a pervasive lack of understanding and lack of knowledge about the role palliative care can play for the terminally ill. Our country is long overdue for a frank, blunt conversation about the limits of technology and the limits of our humanity. The inconvenient truth is we are not perfect and we are not immortal. Money-back guarantees can&#8217;t heal our system.</p><style>
.neFileBlock {
	margin-bottom: 20px;
}
.neFileBlock p {
	margin: 0px 0px 0px 0px;
}
.neFileBlock .neFile {
	border-bottom: 1px dotted #aaa;
	padding-bottom: 5px;
	padding-top: 10px;
}
.neFileBlock .neCaption {
	font-size: 85%;
}
</style>
<div class='neFileBlock'>
<div class="neFile"><img class="neImage" src="https://www.timesleader.com/wp-content/uploads/2016/04/web1_MatusForPrint-1.jpg">
<div class="neCaption"></div></div><div class="metaInfo"><photo0>https://www.timesleader.com/wp-content/uploads/2016/04/web1_MatusForPrint-1.jpg</photo0><caption0></caption0><photoCredit0></photoCredit0></div></div>
<div class="metaInfo"><bylineMeta><p>Justin Matus</p><p>Guest columnist</p></bylineMeta></div><div class="metaInfo"><shirttailMeta><p>Justin Matus is a professor in Wilkes University&#8217;s Jay S. Sidhu School of Business and Leadership who specializes in the business of health care.</p></shirttailMeta></div>

Justin Matus: Money-back guarantee bad deal for health care