The delivery system functions more effectively when people seek and receive care in the right setting, as HIP incentivizes its members to do. When members choose the emergency room (ER) for care that could have been more appropriately provided in a primary care setting, they are subject to an $8 co-pay, which rises to $35 dollars for each subsequent inappropriate use of the ER. Members who are unsure about where to seek care can call their health plan’s 24-hour hotline and speak to a nurse about their health situation. The State reports that the co-pay feature has consistently resulted in fewer inappropriate ER visits by HIP members when compared with people on traditional Medicaid.
I agree that doctor burnout is a public health crisis, with 40-55% of the profession burnt out. However, we will not eradicate this issue until we see and value doctors as human beings, just like everyone else. In that we need to foster working environments that are caring, considerate and nurturing of the very people who are our health care providers, and provide them with support rather than heaping expectations and demands on them and placing them on the firing line of a harsh and punitive ‘regulation’ system which sits there to destroy reputations rather than supporting ongoing learning. Its not enough to ‘measure’ clinician well-being as another performance indicator, we need to take systematic responsibility for the well-being of all, and adjust all systems to make them supportive of all people.