Episode 47: Why doesn’t my doctor know me? An examination of healthcare’s systemic failures featuring Dr. Ilana Yurkiewicz
Ever experienced the frustration of feeling unheard, hastily ushered away, and checked off during your appointments? Or perhaps you've caught yourself making life-altering decisions hastily during your visits with your primary care provider? Join us in this episode as we unravel the systemic reasons behind these challenges and receive actionable tools to empower yourself, becoming an advocate for your health.
Key Highlights:
- We get a peek into a typical clinician’s workday and the structural issues within it.
- Three ways the healthcare system is fragmented: medical culture, loss to follow-up, and technology—and how they impact patients.
- The issues with finding primary care for cancer survivors and why post-cancer treatment is arguably the hardest part of the journey.
- What can you, as a patient, do to improve your visits?
About our guest:
Dr. Ilana Yurkiewicz is a physician at Stanford University and a leading figure in cancer survivorship and oncology-hematology transitions. With an M.D. from Harvard and a B.S. from Yale, she co-directs Stanford's Primary Care for Cancer Survivorship program, offering innovative primary care for cancer survivors and those at elevated genetic risk.
Her medical journalism, featured in outlets like Scientific American and STAT News, includes an acclaimed investigative piece on fragmented medical records. Her latest book, "Fragmented: A Doctor’s Quest to Piece Together American Health Care" delves deeper into medical challenges and was released in July 2023.
Check out “Fragmented” here: https://ilanayurkiewicz.com/book
Key Moments:
At 3:13: “It takes between 14 and 62 clicks to order a Tylenol, something that is a simple over-the-counter medication. And again, that paper showed that the confusion in the electronic medical charts caused errors in up to 30% of cases.”
At 26:56 “And why do doctors get such low amounts of time with patients? It's a payment model. It is still primarily in this country a fee for service payment model where doctors and healthcare organizations are reimbursed on a service. Now, what is a service? It can be a round of chemotherapy, a joint injection, or in primary care, a service is an office visit, that face-to-face, meaning nothing else counts as paid work. None of the time that you spend outside the room putting the pieces together of a patient's story counts as paid work.”
At 40:54
“We need time to make decisions, which is separate from time to manage symptoms and side effects and deal with other things, other concerns, and preventative health… That is what I try to do within my own practice. But we are limited by so many external barriers, many of which we have talked about in this podcast, and a main one here is the time again. We are limited by 10 to 15 minute appointments… How can you make these life altering decisions within 10 to 15 minutes, much less address everything else?”
At 46:05 “You cannot assume that your providers have all of your information or that they don't have it in a garbled way. They don't have it in a meaningful way. And then you are also the agent in making decisions about next steps that affect your health and your body. Your providers are invested in your health, but nobody is more invested than you and nobody knows you the best.
YouTube Chapters:
0:00-0:50 - Introduction
0:51-4:10 - Scattered Medical Data
4:11-11:22 - The Day in the Life of a Clinician
11:23-15:25 - The Fragments of Healthcare
15:26-28:19 - The Consequences on Cancer Patients and Survivors
28:20-45:26 - How to Navigate the System Better
45:27-48:35 - Final Words of Advice
YouTube Tags:
Manta Cares, healthcare, american healthcare, primary care physician, primary care, cancer, oncology
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