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The Importance Of Patient-Centered Care In Texas, Where 30 Percent of Deaths Are Preventable

Data from the Centers for Disease Control found the five most common preventable deaths in the United States: Diseases of the heart, cancer, chronic lower respiratory diseases, stroke or cerebrovascular diseases, and unintended accidents. Now, how do providers and patients avoid these?
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Steve Love, head of the Dallas-Fort Worth Hospital Council, recalled a recent conversation he had with a cardiac surgeon who relayed a story about a patient of his. The man was obese, suffering from type 2 diabetes. He needed a heart valve replaced—a potentially risky, invasive surgery.

The surgery was a success. The first time he returned for a checkup wasn’t.

“He came to his first follow up in the office with a pack of cigarettes,” Love recalled. “He said, ‘this can’t be, we’ve got do a better job. You’ve got to stop smoking immediately.’”

The story illustrates data from the Centers for Disease Control regarding the five most common preventable deaths in the United States: Diseases of the heart, cancer, chronic lower respiratory diseases, stroke or cerebrovascular diseases, and unintended accidents.

New Jersey-based healthcare consulting company Zweena parsed the CDC’s data and built infographics illustrating rates of preventable death in each of the 50 states. Texas plunked in the middle of the pack.

According to the CDC, 30 percent of deaths here were preventable compared to the national average of 28.9 percent. Of 64,007 observed deaths, 19,020 potentially could have been avoided by, say, quitting smoking, eating better, wearing a helmet on a motorcycle. Mississippi had the worst average of all states, with 49.41 percent potentially preventable.

However, physicians say they feel healthcare is poised to whittle away at preventable deaths through improved education, technology, and patient empowerment.

“There’s a lot more education for the patients versus when I graduated, when it was more like dictating to the patient, ‘You do this, and this, if you don’t do it, OK, fine,’” said Dr. Nancy Georgekutty, a family medicine physician at Methodist Mansfield Medical Center. “Now, we want the patient’s feedback. Did you understand everything the physician told you? Did you feel you were being taken care of?”

Georgekutty graduated from medical school in New York six years ago and landed a job in Texas. Even in that relatively brief timeframe, the board-certified physician said she’s noticed positive change in the way healthcare is delivered.

The rise of medical homes and accountable care organizations place more responsibility on the caregiver to ensure the patient lives healthy once they leave the office. There are more educational classes, more of a push for smoking cessation, more options for consulting and support groups. Plus, technology has improved markedly in such a small time; it’s as simple as being able to receive follow up material in an email instead of in a stack of papers.

“They can obtain a lot more information from the doctor’s office,” Georgekutty said. “If they have a question, we’re able to get to them quicker so we’re not looking at questions that go unanswered for months and months at a time.”

Yet the fact remains: The simple, yet sometimes incredibly trying, tasks of getting the patient to rid themselves of their vices remains the cornerstone at slicing preventable diseases in the state of Texas.

The biggest, of course, is smoking. Tobacco use is linked to four of the five preventable causes of death. Then there’s diet and exercise—their effects on a person’s blood pressure and weight can be measured in increments. Georgekutty likes setting realistic goals and following up with the patient shortly after the initial consult.

Employers are also teaming with insurance companies to develop motivators to get their employees to live healthier. Smokers may pay a higher premium. So too will obese men and women without thyroid issues.

“We need to get patients to really focus on their health and wellness,” Love said. “That’s when we’re going to see change.”