mandag 31. oktober 2011

Healthcare choices

Lately I've been interviewing pediatricians. Soon-to-be-parents are expected to do so over here. I've made phone calls to their offices, asked if I can do a "prenatal interview" with specific doctors and booked appointments for that. The doctors I have chosen to talk to are carefully selected from internet research and reputations in my network.

Would I have done this in Norway? Never. Would any doctor in Norway spend time talking to anybody that might choose to see them regularly with their child in the future? ...

At first, I found this a bit overkill - how am I suppose to know what to look for? How much am I expected to know about healthcare to actually be a decent parent over here??

But I think I've managed to find a good doctor to follow up on our child once he's born. Choosing a healthcare provider is like choosing any other service - comparing general impression and gut feeling for the different overall experience; Did I like the doctor? Did he or she listen to my concerns? Could I easily understand what the doctor was saying? Was the waiting room comfortable? Clean? How did the receptionist welcome me? Did I wait for a long time before I was seen? Does it seem to be easy to get hold of the doctor in an emergency? And so on.

My final choice is based on everything else but judgement of their actual medical skills, which I obviously wouldn't be qualified to have an opinion about anyways. Besides, the internet screening sort of covers that part, revealing education, awards, years of practice, medical malpractice records and user reviews. The interview is all about the highly significant people-handling skills and general personal impression, which is what distiguish one recomended doctor from another.

This whole interviewing experience has made me feel quite empowered as a user. I've now made a concious choice based on personal research to ensure that my child will have the best possible healthcare once he's born. It is a step away from being able to blame the system if things don't work out, and two steps towards taking that responsibility myself. It felt scary at first - but it feels good now. It requires time and effort, but then again - it might save stress, time and concerns once we start using the chosen service. I wish I knew this when I was looking for a provider for my pregnancy appointments.

This is not an appraisal of the general American healthcare system. But there are pros and cons. Some of the cons are that you can choose among plenty of good doctors due to the way things work, and the power of the users of the healthcare services is definitely more dominant here than back in our social healthcare country. Bearing in mind that the powerful user would be the resourceful, critical, aware and educated user who's on a good healthcare insurance plan, and who's gained some experience on how things work.

It makes me think about how I've maneuvered our healthcare system back home on different occasions. Have I kept seeing a doctor I don't really like several times because I think it is too difficult to switch? Yes. Have I ever chosen to pay for my appointment at a private practice to see a specialist because they can see me faster? Yes. Have I ever chosen to return to a private practicioner and pay every time simply because the office is nicer, the doctor is friendlier and staff is more welcoming? yes ...

American and Norwegian healthcare systems are very different on many levels and hard to compare, but depending on what health issue you have - whether you are here or there, you are sometimes likely to face stressors that you wish you didn't have to deal with in those cercomstances. In America, finance and insurance might be your biggest concern, in Norway, waiting in line and lack of information may add to your pain and frustration. Either way you find yourself wishing things were different, that those obstacles between you and healthcare where not there.

Having experienced both systems I'd say I still prefer social healthcare to the insurance healthcare. Knowing that you will be seen regardless of your life situation is, to me, invaluable. But there are definitely quality benefits of the power of choice that are worth reflecting upon. What if our social healthcare system was open to free choice and consumer ratings? What if you could choose to go to a specific medical center simply because you've learned that they perform better knee surgery with faster recovery, without having to pay private fees? And you'd be able to ask for a specific doctor to perform the surgery? What if hospital mistakes were publicly broadcasted and medical staff with unstable records were tagged with this on their online profiles? What if part of the health budget were distributed based on performance statistics, consumer feedback and number of visits ...?

Would this rock the foundation of a social healthcare system - or could it improve the quality of the service? Can public opinion serve as a motivator for quality performance regardless of profit and fear of lawsuit? It could at least make the the voice of the user matter more. And perhaps it could force the users into becoming more aware and responsible as social service consumers ...

søndag 30. oktober 2011

Good things in life

Sometimes it strikes me how easy it is to feel happy. Other times it seems like the most difficult and hard reaching feeling in the world. But on a regular day, when nothing extraordinary is on the agenda, it's quite possible to identify some details that make you feel good. Here's a list of general things that made me happy today:

1. eating good food
2. reading good news
3. digital stuff working the way I expected
4. hearing an old tune that brought back good memories
5. chatting with good friends
6. a good hug from the one I love
7. being inside in a nice dry home while it's raining outside
8. looking forward to seeing a good film
9. knowing there's ice-cream in the freezer
10. having time for a nap - and managing to sleep

if you turn this list around, you might have the perfect description of a miserable day:

1. eating crappy food (and paying for it)
2. reading bad news
3. digital stuff that never works the way you expect
4. hearing an old tune you hoped you'd never hear again
5. not getting hold of your friends when you need to talk to them
6. rejection from someone you love
7. being outside in the rain far away from home, freezing
8. NOTHING to watch on TV
9. ice-cream tub in the freezer is empty
10. needing a nap, but too much stuff on your mind to be able to relax

... so getting out of bed with the right leg first kind of makes sense. It is interesting how subtle details can influence your day without you even noticing. Count the blessings ...?