Each year, Americans spend more on alcohol and cigarettes than they do on health care, Todd Richter, a health industry investment researcher for Banc of America Securities, told the more than 100 American Association for Homecare members and guests gathered at their Leadership Conference last month.

“Everyone is worried about the increasing cost of health care. Why hasn’t anyone stood up and said, ‘We don’t spend enough on health care’?” he asked.

Richter thinks consumers will pay more for quality care, but the problem is that many of the people who need home care are critically ill and have limited financial resources. The rest of society must help carry the cost for their care. And it is a lot easier to convince someone to buy a personal, easy-to-understand benefit, such as the enjoyment derived from a beer or a cigarette, than to spend money on an altruistic, hard-to-understand benefit, such as home health care.

To my surprise, I heard that even the ultimate health care experts, the physicians, still lack basic information about home care, and patients are suffering as a result.

“It is a little bit embarrassing, as a physician that physician education is a big source of the problem,” said David Baratz, MD, president of Pulmonary Associates, Phoenix, and clinical assistant professor of medicine at the University of Arizona.

The university may have as many as 100 residents at a time, and they receive little home care training, he told conference attendees. “I see physicians mismanaging basic sleep apnea,” he said. “If we can educate the physicians a little more, we can bring more value to the patient.... I think there are a lot of physicians that just order home care and don’t really know what it involves.”

A Los Angeles provider I spoke with at the conference confirmed Baratz’s assertions. Physicians often counted on her to tell them what products and services would be most appropriate for sleep-disordered breathing and other noninvasive ventilation patients, she said. Furthermore, when patients that she has served end up returning to the hospital for additional treatment, their quality of care actually suffers because the hospital staff is not as experienced as her company’s staff when it comes to noninvasive ventilation.

Speaking on the condition of anonymity—she feared that criticizing hospitals and physicians could harm her referral source network—she described how she recently had to visit a 37-year-old quadriplegic arterial lateral sclerosis patient in the hospital and plead with the staff to let him use his noninvasive ventilation home system and settings because the hospital system was causing him problems.

In this country, we believe in physicians. We trust that all those years of education somehow make them less prone to mistakes. But often, humble HME and oxygen providers may beat the learned doctors because they work more closely with patients and ask the right questions.

Despite decades in home care, Joel D. Marx, this month’s guest editor, is the first to admit he doesn’t know it all. He is constantly learning, and trying to educate those around him at the same time. As chair of the Sleep Disordered Breathing Task Force, he hopes to improve the lot of providers through education. From what I heard at the Leadership Conference, he is on the right track.

To do our part in furthering education and serving you better, we are premiering a new section this month. On page 17 we begin “Mobility Today,” a bimonthly section that will alternate with “Respiratory Today,” a new section premiering in the April issue. In these two sections we will bring you the latest on these dynamic home care topics. Enjoy!

Lena Lindahl
llindahl@medpubs.com