"A Way With Words" I love words and language. Honest. I studied journalism in college and have always enjoyed writing and of course, reading. I enjoy figuring out the best words to use, taking note of language that may not be the most appropriate, and wondering where terms came from.
As a side note, ever wonder where the term "kit and kaboodle" came from? When we talk about the whole lot of something, we call it the whole kit and kaboodle. But what's a kaboodle? In Dutch, a "kit en boedel" refer to a house and everything in it. For the sake of the English idiom, we just slapped the "k" in front. Voila, kit and kaboodle. Great descriptive term.
But, lest I digress even more, let's get back to healthcare. If you've been paying attention to any of the recent discussion about healthcare, you may have noticed alot of new terms, new words, and new ideas being discussed in newspapers, magazines, and healthcare related journals. Some of them give me pause. Some of them make me want to scream. And some of them just make me chuckle. Consider the following: 1. "Minimally invasive surgery"--Somewhere in a surgeon's office, there is a conversation going on between doctor and patient where the discussion of surgery is on the table. (No pun intended). The phrase "minimally invasive surgery" is offered as one of the options....can you imagine the patient saying, "Oh, no thanks, Dr. Smith, I'd prefer to have the maximally invasive surgery!" 2. "Nerve sparing surgery" --Same conversation in another surgeon's office only this time it's another body part. The surgeon says to his patient, "One of the procedures we now offer is a nerve sparing surgery which minimizes the amount of trauma done to your nerves." Again, do we think patients are stupid? Who in their right mind is going to say, "What? Nerve sparing surgery? Forget it, Doctor. I want as much damage done to my nerves as possible! Bring on the nerve damaging surgery!" 3. "Patient Centered Care"---Throughout the myriad discussions going on about healthcare reform, this term keeps popping up. As a nurse, I have always found this term a bit disquieting as nurses, throughout the history of nursing, have practiced patient centered care their whole careers. One can only assume that the bureaucrats and the folks at the healthcare reform table (wherever that is) are figuring out what nurses have known all along----"it's about the patient, stupid!" And the quicker that our healthcare system really makes it about the patient, the better off it will be. 4. "Accountable Care Organization"---Also known as an ACO. (Healthcare loves acronyms as much as the government or the armed services.) This term was coined by the National Committee on Quality Assurance (NCQA) after it introduced its new medical home model. According to the NCQA, "an ACO is a provider-based entity that has come together with the shared goal of taking responsibility for improving quality of care and reducing cost growth for a population. Funny, "accountable care" is being presented as a new concept as though previous to this, there was no accountability. 5. "Patient Centered Medical Home" (PCMH)---initially termed by the American Academy of Pediatrics in 1967, this is now the rallying cry for healthcare quality and reform as having a medical home (of course, patient centered) has been associated with better access to care, more preventive screenings, higher quality of care, and fewer racial and ethnic disparities. Wonder what Thomas Wolfe, who wrote "You Can't Go Home Again," would think about the patient centered medical home? 6. "Patient Centered Healthcare Home" (PCHH)---in an attempt to be more inclusive, "healthcare" was substituted for "medical." This concept was brought to life by the National Committee for Quality Assurance (NCQA). The PCHH is a health care setting that facilitates partnerships between individual patients, and their personal physicians, and when appropriate, the patient's family. Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner. Sounds perfect, doesn't it?
7. "Quality Patient Care"---as opposed to atrocious, lousy, or pathetic? In this term, we must assume that quality is used here as an adjective for 'fantastic,' 'excellent,' unsurpassed.' Just for fun, what if some organizations starting using some new slang terms like "dope,' 'down,' 'radical,' or 'phat?' I'd get a kick out of seeing an ad that said, "Phat Patient Care!"
8. "Pay for Performance" aka P4P---For a good example of this concept, consider the new contract of Albert Pujols', former St. Louis Cardinals first baseman. Albert was paid for his MVP performances with a 10 year, $254 million dollar contract with his new team, the Anaheim Angels. Not bad, huh? But in healthcare? This payment model rewards physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures for quality and efficiency. I think P4P would be alot more successful if we started paying patients for their successes! Why shouldn't healthcare providers share their P4P with the patients whom they performed on! Happy Holidays to All!!!
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