Looking at my HMO versus the PPO my mother has, I can really see the advantages of going with an HMO. I’m thankful to be with Kaiser Permanente, which offers HMO medical insurance. HMO stands for “Health Maintenance Organization”. The doctors are part of a network and my medical records are integrated. This means my doctors work like a team. Any of them can readily step in. Any of them can access my medical records at anytime. I don’t have to wait to speak with the last medical professional I saw or try to remember what the different doctors said. There’s no waiting or guesswork on who did what, why, or when. It’s seamless medical care.
My Mom is on a PPO (“Preferred Provider Organization”) plan. Her doctors and nurses have been exceptional: caring, professional, and knowledgeable. However, there are challenges when it comes to communication and medical records. The right hand doesn’t always know what the left hand is doing because the medical information is not readily accessible. This means when she’s at a hospital, the treating doctor or doctor on duty may not be in communication with her regular doctor. So when we need updates or additional information, it is often up to us to do the legwork. Sometimes, it’s like pulling teeth. Here is my family’s recent experience:
My Mom has had several medical issues this year. She’s frequented at least 4 different hospitals and had multiple emergency room visits. Recently, Mom was admitted for a peg-tube complication. She was released after a 3-day stay. When she came home, she was confused, agitated and quite feisty, totally unlike her usual self. Ordinarily, she is mellow and sweeter than pie. The strange behavior prompted me to call the hospital that discharged her. I was advised that it would be best to speak with her regular doctor. Her regular doctor never saw her at the hospital, so I asked who else could help me. The nurse recommended speaking with the last nurse who took care of Mom, except she had already left for the day, so best to call her regular doctor after all. Eventually, the nurse suggested I speak with the Head Nurse. The Head Nurse said to consult with the treating physician. But the treating physician advised her to have me consult with the doctor who released her, except she too was gone for the day. I was thankful the nurse decided to help me herself. I realize she had to bypass hospital protocol, but it was a good time for good sense.
Mom’s experience has made me more grateful to be with on an HMO with Kaiser. There may be a different kind of red tape, but at least, the medical professionals would have been better-able to coordinate. The right hand and left hand would have worked together in providing good administrative support on top of great medical care.
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