Scenario One: You are the director of a hospital which is treating a patient with a life-threatening illness. The patient cannot afford the extremely expensive medical care. What would you do?
Scenario Two: You are the director of a hospital and hundreds of the hospital’s patients have this life-threatening illness. None of the patients can afford the extremely expensive medical care. What would you do?
When I was given these prompts in my undergraduate bioethics class, we were asked to provide theoretical responses and valid justifications. Reading scenario one, I immediately put myself in the patient’s shoes. Of course I would do everything in my power to provide treatment for this patient, regardless of his or her ability to pay. Scenario two, however, challenged me to realistically analyze the hypothetical cost of care, availability of resources, and other such factors. Suddenly, my feelings of empathy clashed with my logical reasoning. Could I resolve the dichotomy between how I would act for an individual person with how I viewed treatment of an entire population?
Spending this year serving as a patient navigator at the Pittsburgh Mercy Family Health Center, I have gained some insight on how an organization can realistically deliver quality healthcare to vulnerable populations. Pittsburgh Mercy’s integrative system provides physical and mental health services to those in need, and Pittsburgh Mercy continuously aims to enhance service components such as access, delivery, and follow-up to care. I have learned that the implementation of innovative ideas like targeted team approaches to managing care, coupled with systematic changes that focus on improving value, can address some of the difficult issues of providing care to the vulnerable in our community.
When I start medical school this summer, I will enter with a new mindset about my future role in the healthcare field. I have often heard the expression that the days of the “cowboy doctor” -- physicians who are extremely independent and rely heavily on their own individual judgments -- are long gone. In fact, I believe that physicians are only one part of a field that requires numerous components to function.
In order to make large-scale improvements in the implementation of health care for all people, a person-centered, holistic, team-based, systematic approach -- like that found at Pittsburgh Mercy -- is not only necessary, but also essential. Members of the current Pittsburgh Health Corps cohort have a wide range of professional interests and aspirations, including public health, nursing, law, and the economics of health care. In our future careers, I know that we are all committed to interdisciplinary collaboration in order to lower healthcare costs while also improving the health of individuals and our communities as a whole.
Above: Working as a team, a Physician’s Assistant, Medical Assistant, and Patient Navigator spend the beginning of every morning discussing patient care management at the Pittsburgh Mercy Family Health Center.