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How Carefully Do You Choose Your Health Care Provider?

If you’re like most Americans, you probably didn’t take your hospital for a “test spin,” you didn’t bother with the consumer ratings, and you certainly didn’t look beneath the hood to make sure everything’s running smoothly.

The fact is that most health care consumers spend far more time mulling over which car — or even television– to buy than they do thinking about the qualifications of their primary care doctor.

It’s a persistent problem that struck a nerve with the Robert Wood Johnson Foundation.

Throughout September, the foundation’s “Care about Your Care” initiative is calling on Americans to wake up and take control. Dr. Risa Lavizzo-Mourey, the foundation’s president and CEO, explains:

Health care in the U.S. might be more expensive per person than any other nation in the world, but that doesn’t mean a patient will receive the recommended treatment for their condition. In fact, the odds of that happening are about the same as a coin toss – adults get best-practice care just over half of the time. Children receive it just 46.5 percent of the time.

“We have miracles that are created every day in our hospitals. But we also have tremendous variation in our care and gaps in our care,” said Lavizzo-Mourey said. “We’re not consistent.”

According to the foundation – which is one of several underwriters of the NewsHour’s Health Unit – there’s a lot that individuals can do to beat the odds. Among them: Talk with your doctor or nurse about what matters to you. Ask questions and take notes. Learn about the best treatments for your conditions, and then make sure your doctor knows them, too.

“We have learned by looking at communities all across the country that if consumers get engaged, if they start asking questions, if they start investing in their own quality of care, that care for the entire community goes up,” Lavizzo-Mourey said.

According to RWJF, 40 surgeries are performed on the wrong patient or on the wrong part of a patient’s body each week in the United States.

And despite state-of-the-art facilities, expensive technology, and extensive training, more than 100,000 deaths occur in the United States following surgery each year. Half of them are avoidable. Those stats are from a recent book by Dr. Atul Gawande, a general surgeon at Brigham & Women’s Hospital in Boston.

So Gawande devised a simple solution to help alleviate these problems: the checklist.

Gawande believes the lists — which RWJF also recommends as a key way to ensure safety in the operating room — could be a key to revolutionizing the industry. He spoke with NewsHour Health Correspondent Betty Ann Bowser shortly after the release of his book, “The Checklist Manifesto.”

But are those simple checklists – or any other recent innovations in the medical world – moving care in the United States in the right direction? According to Lavizzo-Mourey, the big-picture answer is no.

“When we look at how well the disparities in this country are, over time, they’re about the same,” she said. “There may be some areas where they’re slightly better and others where they’re worse, but overall the trend is that they’re about the same.”

That doesn’t take away from the success sprouting up in “pockets of innovation” nationwide, she said. In some places, for example, hospitals are looking at how they can measure their health care data, stratify it by race and ethnicity, and use the numbers to improve care. In other places, the innovation has risen from the community – including local efforts to bring down health care costs throughout the system by curtailing the runaway childhood obesity epidemic.

Particularly among young children who live in low-income families, “we’re starting to see the overweight and obesity rates going down,” she said.

Increasingly, schools have also begun providing more healthy options in their cafeterias and community leaders are examining policies that would help make healthy food options a default rather than a luxury.

On a recent reporting trip to the Mississippi Delta, Bowser visited one such community trying to set a healthier course.

Each year, 91,000 people die from bad care for conditions like high blood pressure, diabetes, and heart disease, RWJF reports. Thirty percent of health care spending comes from services that may not even improve health. And if all ill patients had a follow-up plan for their care, 75 percent wouldn’t need to return to the hospital. That’s just naming a few.

“So we’re seeing hopeful signs, but sadly, overall, the trend is about the same,” she said. “And that’s one of the reasons that we are encouraging consumers of every race, ethnicity, to get engaged in their care. Because we do think consumers will drive this if they’re more engaged.”

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