How healthcare innovation helped save my life | Employee Benefit Adviser

I’ve been thinking a lot about healthcare disruption lately, partly because of my own medical crisis, which I mentioned in my last column. I detailed some of my frustrations as a patient: navigating a flawed health system, lack of transparency, surprise costs, billing errors and so on.

But what I didn’t mention was that there was some glimmer of hope in the situation — and it had to do with new ideas and going against the status quo. The truth is, healthcare innovation in part saved my life.

Around Thanksgiving last year, I found myself getting sicker. I was lethargic and short of breath, with a nagging cough and chest pain. But I didn’t have pneumonia, or some other virus. “I’m sick, but I’m not sick-sick,” I told my doctor. There I found out my pulse oxygen had dipped into a percentage in the 80s, I was tachycardic and had high blood pressure, along with a slew of abnormal blood results.

I was sent to the hospital to get on oxygen and also to undergo tests for any glaringly obvious problems, including pulmonary embolism and heart failure — all highly desirable diagnoses for a 30-something, right?

Every day my doctor texted me: “What’s the latest?” “Are you OK?” “How are you?” “Have them test for X, Y, Z.”

The truth is, I pay her for this relationship: Since last fall, I’ve been participating in a direct primary care model, where I pay a flat monthly fee to see my primary care doctor an unlimited number of times. My employer doesn’t pay for it, though I still purchase regular coverage through them. This is something I chose to do on my own, after a lot of hemming and hawing over the additional cost. But I’m a patient with a complicated medical history, so the plan seemed worth it for the same price I pay for my cable TV.

My doctor said she left traditional practice behind because she was frustrated by insurance barriers and the lack of relationships with patients.

Her move ultimately resulted in my favorable outcome. My first hospital stay brought the wrong diagnosis and me being sent on my merry way (and by merry, I mean on supplemental oxygen, barely lucid and cyanotic).

Despite it being the weekend, I spoke to my doctor right after I was discharged. She told me to immediately get to a different hospital and called the ER with instructions and requests for specific testing. The result? The correct diagnosis and treatment, plus the shocking revelation that, had I not gone back to the hospital, my organs would have started to fail and I likely would have soon died. (For those of you curious about my plight: A rare blood disorder was causing my body to not distribute oxygen to the tissues properly, further complicated by an autoimmune disease.)

A decent, concerned and available doctor shouldn’t be the exception, but in our traditional health system, access is a problem. Previously, attempting to get in touch with my doctor usually involved leaving voicemails, fighting with office managers or pleading to make an appointment less than a week out. But the direct primary care model had me in constant conversation with my doctor at a time I needed her most, by phone, email and text. When I was finally discharged and slowly healing, I had follow-ups every few days for several weeks.

What if employees — especially those with chronic conditions or a disability — had better relationships with their physicians? Or better yet, better relationships with healthcare?

What if direct primary care was a workplace benefit offering? More importantly, what if both employees and employers said enough is enough to ridiculous costs, poor quality, long wait times and insufficient attention to chronic (yet often manageable) conditions? What if we bucked the traditional healthcare system and tried other solutions? (Read more about this in my story, “How 60 of the nation’s biggest employers are uniting to fight the benefits status quo.”)

Healthcare cannot go on as it has been if we want things to change.

“It’s the definition of insanity,” Michael Laquere, CEO of the Employer Health Innovation Roundtable, an employer group, told me. “You can’t keep doing the same thing and expecting different results.”

Solutions must go beyond what health plans traditionally look like — and employers must help in driving them. Think beyond what you know and what you have always done. As I discovered firsthand, you just may save a life.

This article originally appeared in Employee Benefit News.

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