Calling Dr. Costco

I decided a year ago to take a break from writing about healthcare. After all, the end of Covid was in sight.

My former organization had set an excellent example of how to roll out an effective vaccination program and my last posting in January 2021 proudly boasted about that while drawing a comparison to the lumbering giants in healthcare. That was a theme I have often returned to.

I also felt that even though I was getting increasing visits to this site that there was only so much complaining you can do about about Medicare and MediCal and I had exhausted those subjects. For those reasons, I decided to take a “brief” sabbatical that stretched out to more than a year so I could concentrate on other things.

During 2021 I lost twenty-five pounds thanks to my Peloton bike and assorted other torture instruments in my home gym. Covid had closed my favorite gym and it remains closed today. I learned though that working out at home gave me more focus in attaining enhanced fitness. COVID forced me to reevaluate my fitness regimen.

I also decided to try a diet plan which would provide me with frozen meals. Being a picky eater, I survived on only two selections for lunch and four for dinner for six months. I do not want to see another chicken enchilada dinner for the rest of my life. It worked though and I am back on a regular diet just less so and my weight has stabilized at an older college version of myself.

Newly thinner and but still lazy me also spent some time investigating the use of artificial intelligence in writing. There are some really interesting but expensive apps available which can provide great assistance in that regard. Editors may soon be replaced by apps! So may writers.

I also had an opportunity to step back and observe how healthcare is delivered and came to some uncomfortable realizations. I discovered it was much easier to get subsequent Covid vaccinations as well as my annual flu vaccination at……….Costco!

You could find me several times during 2021 patiently waiting at the Costco pharmacy area for my appointed vaccination time, complete with a basket full of gallon jugs of ketchup (a lifetime supply for me) rolls and rolls of toilet paper which I tried to hide down in the lower reaches of the basket (it’s embarrassing) and a $35 jacket which looks suspiciously like one I had spent $150 for two years earlier at a department store. I also noticed that the warehouse big box store offered hearing and eye services as well. Costco delivered healthcare services so conveniently and inexpensively that I began to wonder why healthcare providers could not be more like Costco.

Then there was the lesson of coordinated care or, more aptly, uncoordinated care. I was asked several times by family members and friends in California and elsewhere to provide advice on coordinating services. You know, things as simple as getting follow-up care with specialists within the life expectancy of the patient. I was tempted to call Costco for advice.

What I learned is that navigating healthcare is so difficult that often patients are harmed not because of errors but because they have no one to assist them navigating the system. This is even true of very large organizations which like to boast of their strength in this area.

One family member out of state was hospitalized for a serious condition and then at discharge was left to figure what to do next. Another family member is in constant battle with her insurance to get covered services pre-approved without a long waiting period. Yet another must try to coordinate her children’s healthcare needs without much assistance . I learned of other examples in the past year as well.

It has been almost five years since I retired. I have since come to the conclusion that when care is provided it most often is of high quality . Where we fail, though, is making sure that there is continuing and appropriate coordination of care and that should be the responsibility of healthcare systems. Don’t expect health plans to do it. No organization does a consistently good job of that.

Covid has forced many changes in the delivery of healthcare. We have learned how valuable our healthcare workers are and how dedicated as well. The most important change yet to come is the effective use of human resources and information technology to make sure people get the care they need when they need it That is a lesson still to be learned. I think Costco has.