This is the first in a series of scenarios designed to illustrate what changes might look like with the implementation of the Affordable Care Act (ACA). Each scenario presents a snapshot from a patient, healthcare, or business point of view. If you haven’t been to the doctor recently, read on.
2012: PETER THE PATIENT
Peter is an aging baby boomer with heart disease in rural America. He has delayed seeing his cardiologist since he feels he has done well maintaining his health. However, troubling symptoms have arisen, but he thinks a pill should take care of it.
At the cardiologist’s office there is more staff than he remembered and a much longer process recording his health information. The typical magazines in the waiting room have been replaced by American heart Association publications and WebMD magazines. He settles down to wait.
When Peter is called back for his appointment, he is again asked for his birth date and primary care physician’s name before stepping on the scale for his weight. It is a new, electronic scale that gives a digital readout. It looks expensive.
Peter notices a lack of paper. There are computer stations everywhere, but no thick patient files in view. It is the same in the exam room. There is a keyboard, flat screen and nothing else. The nurse enters updated medicines and diagnostic information directly into the computer and refuses the paper copy that outlines Peter’s recent medical history.
The doctor conducts a typical examination. He rapidly scrolls through what is apparently Peter’s file on the computer and enters something on the keyboard. He tells Peter that the blood tests taken at his primary care physician’s office a few days ago will arrive in just a moment and asks the nurse to request them.
Meanwhile, Peter explains his symptoms. An EKG is completed right there in the room, where an irregular heartbeat is discovered. He is fitted with a heart monitor that continually transmits his heart rate to a site inSt. Louis. He is taught how to enter his symptoms into a hand held unit that transmits it to the same place. He will wear the unit for three weeks, and then return for a follow up appointment once the doctor receives the report. In the meantime he is given a new prescription to address his symptoms.
At the appointment desk Peter makes a follow up appointment, repeating his birth date and primary care physician’s name. He is scheduled for further tests providing his condition is stable.
Peter thinks about the changes he has seen. He is happy that his insurance coverage is in place, but questions the number of tests ordered. The appointment had been much shorter than the wait. Peter decides to educate himself about his condition. He realizes that he must become a partner in his health care, not a passive recipient. Relying on a pill alone is not going to work. Things are changing and he must adapt, like it or not.