I’ve been in the field of public health for almost 30 years. ‘Continuity of care’ has become an international buzzword, (in Israel as well). In fact, it is considered a basic health right that you may demand when seeking out the same medication, doctor, or treatment plan.
So why was my client left with a serious infection that her doctor knows should be treated, because there’s only clinic that can ‘diagnose her’ and there are no appointments for another two months!
Continuity of care is a general term, but is defined as the right of a patient “to continue receiving treatment for a given illness or medical condition at the same facility or service provider, regardless of any changes with regard to agreements or arrangements.” [direct quote from Israeli healthcare law]
Case in point would be when last year, I had a client scheduled to do a procedure at Hadassah Hospital. In the few months between making the appointment and the actual procedure, Meuhedet, his Health Service, had switched coverage and was only doing these procedures at their own facility. They said they would not cover the procedure. I reminded them that under the law of continuity of care, the client had already made the appt and done the intake for the hospital, and they could not deny my client this service at this particular hospital. Thankfully, they remembered this law and paid for the procedure.
How is this connected to my client’s breast infection?
She just had a baby, and as ~30% of new mothers do, she developed a breast infection while nursing. A serious breast infection that unfortunately led to a complication that needed more than the family dr. She needed a specific ultrasound, well just an ultrasound, but of the breast.
It turns out her Health Service, Meuhedet, only offers that procedure at one facility now, (big change from a couple of years ago), and only with a referral from a breast surgeon.
Now, if you’ve ever tried to make an appointment for a breast surgeon, it goes something like this:
The phone operator: “Well, I have something in September.”
Me: “September?! I need an appointment now. In July! 2022”
The phone operator: “ I mean September, 2023. “
You get the point. Appointments for surgeons are rarer than good political candidates in the Knesset.
So. What did I do? Employed the tactic I call, Firing from all Cannons. This is when you call every place you know and make multiple appointments as you search for the best option:
- Always make an appointment with the Health Services option, even if it is months away. It may be good for a follow-up appt. Or waiting may actually end up being an option, because you will have seen another type of dr in the meantime. At least you will have that option.
- Make a private appointment with a specialist. This can be done by looking up who are private specialists who work with your Health Service so that you can see someone and pay a subsidized amount. Because it’s private the time to appointment is usually much shorter.
- Go further afield. Leave your neighborhood/city and look for clinics or specialists outside of your geographic area. Driving for 45 minutes for an appointment next week is much better than waiting for 3 months for an appointment that is ten minutes away.
I ended up making two private specialist appointments, one private clinic appointment and one public clinic appointment. Now we have choice and more options.
What’s your story of (no) continuity of care?