2.75 Cheers for Kaiser

2.75 Cheers for Kaiser Permanente

I spent last weekend on the San Francisco Peninsula, primarily attending to my mother, who spent the prior week in the hospital. Mom is 13.75 dog years old, and at that age, well, age becomes a conspirator, and you become its plot.

This becomes relevant since her care at the Redwood City Kaiser Permanente facilities is emblematic of how we can deliver good health care, at a reasonable price, even for those in their late, late years.

Part one. She complained about breathing troubles and scheduled a physician’s appointment at Kaiser. In quickly, diagnosed with chronic obstructive pulmonary disorder and hospitalized all within an afternoon. It helps that the walk-in clinic is a stone’s throw, or wheelchair ride, from the Kaiser hospital.

I am not writing here about her transitory mental confusion, the concern over whether she can continue living alone in a retirement community and the need for at least temporary round-the-clock attendants. We’ll save those for another day.

Part one and a half. The attending physician phoned me and spent all the time required spelling out her medical diagnosis (guarded) and various living arrangement options. I decided to check out the situation myself, hence the visit to the Bay Area.

Part two: the follow-up. I accompanied mom on her follow-up visit, about a week after she was discharged. American Airlines thoughtfully contributed to the drama by cancelling my late evening flight back to New York; my rescheduled return gave me just four hours from Kaiser visit to wheels up. Being a New Yorker, I anticipated the horrors of waiting and waiting for her appointment and grinding teeth trying to get back to SFO on time.

But the nice surprises started the minute we entered the clinic. A short line in a comfortable reception area; the request to pony up $10.00 for her visit (I couldn’t get my blood pressure read for ten bucks here in the Empire State), then a short elevator ride up to “clinic F.”

Clinic F was nicely furnished, with magazines from this century; pictures of the physicians staffing the clinic and their bios nicely displayed on the walls. Moments after arriving, mom’s name was called and she was led to her physician, a woman who’s treated her for several years. I am watching the clock. Not bad.

Thirty minutes later I am called into the exam room, where the attentive physician reviews mom’s chart with me, discusses with both us her medication schedule and answers both our questions with alacrity and no sense that she has to make way for the next patient.

All in all, the report is positive and her health improving, though it’s doubtful there are triathlons in her future.

Kaiser Permanente some time ago computerized its medical records, so everything the physician needed to know is at her fingertips. Oops--one problem: the computer crashes, making it impossible for her to e-mail the on-site pharmacy mom’s new prescriptions. So we move to another exam room and a more cooperative computer.

Time elapsed: ninety minutes; seventy of which were with the physician. Then down to the pharmacy, where an electronic display chimed that mom’s prescriptions were ready. The pharmacist threw in one of those weekly pill dispensers for free.

Outside, we passed through the pleasant gardens soaking in the California sun. Then to the street where the Redwood City policewoman waived the red “no parking” regs, so mom could have an easier time getting into my rental care.

Back to her retirement community, a bid farewell, then off to the airport with plenty of time to make the flight.

How does Kaiser manage great patient care, fast service and pleasant surroundings all wrapped in a $10 co-pay?

Medicare helps and don’t let anyone tell you seniors don’t like it.

The medications Kaiser dispenses are not best in class. When have you been prescribed lovastatin, the first “statin” drug, approved about 25 years ago? But lovastatin works pretty well if you don’t have galloping dyslipidemia.

You won’t find Kaiser doctors in Castle Connolly’s “best doctors in America.” Don’t expect Johns Hopkins or Stanford Med graduates. But they are thoughtful, caring and in mom’s case know primary care medicine as well as anyone you could hope for.

Kaiser’s medical information system is seamless, electronically linking departments, clinics and the pharmacy. But if the computers don’t work, you gotta move.

These points contribute to “how does Kaiser do it,” but they don’t fully answer the question. I’d really like someone to enlighten me.

Someone critical of President Obama’s enacted Patient Protection and Affordable Care Act said that sooner or later all of us will be going to Kaiser-like facilities.

If so, we could do a lot, lot worse.