What Do Women Want?

No, it's not the tag line on the cover of Cosmo. It's a survey from the American Academy of Family Physicians. Women make most of the decisions about health care in their families, and not surprisingly, most of them (60 percent overall, 75 percent for the 18-to-34-year-old age group) have trouble navigating the system.

The survey, brought to our attention by Jane Sarasohn-Kahn at the Health Populi Blog, also looked at whether family members go to the doctor only when they are sick, or do they get preventive care. Not surprisingly, most families don't get a lot of preventive care, and the obstacles are largely financial. Time and convenience are also key factors.

The quick retail clinics popping up at malls and drugstores are proving useful, particularly as Sarasohn-Kahn puts it for "uninsured busy moms." Inexpensive and convenient, they can help with, say, a routine childhood illness (is this a sore throat that will go away by itself in a day or does my toddler have strep and need an antibiotic?). But the clinics aren't meant to be a source of comprehensive ongoing care that encompass prevention, early diagnosis, chronic disease management with a doctor who is familiar with the patient and family. They aren't a "medical home."

The women in the AAFP survey may not know the term "medical home" but that's sure what they described, Health Populi concludes:

63% of women want the ability to have a relationship with a doctor who knows [the] medical histories of all family members in order to diagnose and treat the family unit. 63% also highly value one doctor to manage chronic conditions. 62% of women feel it's important to have a doctor to coordinate care with doctors when necessary. And underpinning all of these wants is the fact that most women see technology as an enabling factor in building the Medical Home: wired with an electronic health record, ePrescribing, electronic scheduling, and e-mailing of results.

The AAFP, in its own summary of the survey, said that women reported many ways in which receiving health care was simply a pain in the neck—and the things that bugged them were also the inefficiences and inadequacies that cause waste, unnecessary expenses, fragmentation ,and potential errors in their health care:

• 43 percent of the women reported having to fill out complete patient histories and other forms at each medical provider's office
• 26 percent said they have had to inform one medical provider what another doctor had recommended or diagnosed
• 16 percent have had to themselves carry lab reports, x-rays, and other test results from one medical provider's office to another
• 11 percent have received contradictory recommendations from different medical providers
• Nearly 10 percent have had to repeat lab tests unnecessarily because of lack of communication between medical providers

"These findings point to some of the most important cost-drivers in America's health care system," said Jim King, M.D., president of the AAFP. "A system that is difficult to navigate and relies on patients to deliver tests and communicate diagnoses leads to fragmented care, duplication of tests and sometimes unnecessary procedures—all of which steadily drive up the cost of health care for the nation as a whole."