07 August 2018

Your Doctor Doesn’t Know Which Medications You Take and Jose Doesn’t Live Here Anymore, Stop Sending Me His Mail


            We live in a fractured world. I’m not taking about morals, values, classes, or anything like that. I simply mean that there is no communication between organizations and no central reporting of information, meaning that for most things, you have to answer the same questions over and over and over and over and over again. For example, your physician, dentist, optometrist, pharmacist, and any other healthcare provider you see will ask you many of the same questions: do you have any allergies, do you smoke, do you have any chronic health conditions, etc… But despite the first provider having most of the information that all subsequent providers need, they ask you again separately. And if you change dentists, be prepared to answer all of those same questions yet again. And you will need new x-rays too, because the first dentist isn’t going to share those with the new dentist.
Perhaps it is a result of the American phobia toward all things centralized, despite the obvious monopolies that rule the world, or maybe it is just that nobody ever thought of unifying all of this information, although that is obviously not true, because Google and Facebook are already doing it, just for the purpose of trying to sell you things rather than make your life any easier. This isn’t just some idealistic dream either, other countries have implemented many such central databases. Let’s compare, shall we.
In the United States we have a process called medical reconciliation. This is when a health care provider attempts to create a consolidated list of your medical conditions, which medications you are taking for those conditions, and at which dosages. Let me emphasize that this process should be entirely unnecessary and exemplifies everything that is wrong with our fractured healthcare system. The reason we must have it is because when your heart doctor changes your blood pressure medication, he doesn’t tell you primary care provider, who continues to send in prescriptions to your local pharmacy, but you actually use a mail order pharmacy now, because your insurance prefers it, (requires it or they won’t pay for your medications), but, you forgot to tell your local pharmacy so they continue to fill medications for you, and in the transfer to mail order your cholesterol medication got overlooked, so you just haven’t been taking that one, and so when your hospital doctor asks you what medications you take, you just look at him confused and say “shouldn’t you know all of that.” Yes, they should, but no, they do not, in fact, not one of those groups I named does, because everyone was missing at least one piece of the puzzle. Conversely, Denmark has the National Health Service Prescription Database. Just like it sounds, it is a national database of all prescriptions an individual fills at any pharmacy in the country. Now, this doesn’t guarantee that the patient is taking all of their medications like they are supposed to, but at least the doctor knows what they are supposed to be taking.
Okay, you said the world was fractured, but all I’ve heard are healthcare examples. Don’t worry I have others. Healthcare is the most consequential, but let’s look at one that would be much simpler to fix. When was the last time you got someone else’s mail? I don’t mean the mail carrier put it in the wrong box. It was addressed to your home address but had someone else’s name. Or maybe you get calls every other day from a car dealership trying to reach Tiffany Hays. People move, people change their phone carriers, and the people that inherit their old addresses or phone numbers also inherit all of their old contacts that they forgot to update. How do we fix it? Stop addressing mail to addresses and start addressing it to individuals. Give everyone a national postal number. This number is yours and does not change. When you order a product, instead of a shipping address you put in your postal number. If you want to send your grandson a birthday card, just write his postal number on the envelope. Here’s the kicker, if you move, contact the post office, tell them your postal number and new address. Congratulations, you have just updated your address with everyone. Phone numbers would be a little more difficult, but certainly doable.
I know what you’re going to say, I can hear the protests already. Like I said, the United States seems to have this ingrained hatred of all things centralized. You know, it’s all about the free market and whatnot. But let me remind you, that the abuse is already here. Google already tracks your internet activity. Everything you post on social media or watching on your streaming network of choice goes into an algorithm. These companies know way more about you than just where you live or what your phone number is. And that information is superfluous anyway. Solicitors don’t care who lives at a particular address, they just send out promotional mail to everywhere. At least with my method you wouldn’t have to get other people’s junk mail on top of your own.

-AMS

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