External Influences: A Key to Health Delivery Success

::written circa. Fall 2013

This past Tuesday, for this second week of interviews, I was still fortunate to have spoken with Jennifer Sheckler.  As a recap from last week, Jennifer is currently (and has been for 15 years) the health manager at the Children & Teens Medical Center, in Schaumburg, IL.  Along with a team of health assistants and a dozen of physicians, she manages an outpatient facility that focuses on offering primary care, specializing in family medicine.  Luckily, without piercing her tick point of mind numbing monotony, I was able to gather a few points on her experiences and thoughts on external influences, in relation to health care delivery.

One of the main external factors that were emphasized, which kept most of the conversation alive, was the influence of insurance companies.  We briefly discussed her definition of family coverage plans, but rather emphasized the importance of the “beneficiary” maintaining their employment, for the benefit of their children (Shi & Singh, 2012). Unfortunately, she does recall experiences that were simply out of her control.  Jennifer informed me on the burden of insurance companies.  However, “tedious” was the word she preferred me to use.  She elaborated that the reason why it is essential to focus on external influences is simply because they are constantly changing.  When it comes to insurance, the aspect that we focused on, everyone’s insurance is different, especially in family medicine.  Even though most of the children and teens are under their parent’s work plan, there are still limitations on the delivery of care, depending on the condition the child has.

Jennifer suggested that it is important to be aware of family insurance costs, benefits, premiums, deductibles, etc., because they were all “stratified” in the local community.  She followed this by quoting, “it’s just a lot more precise paper work.”  Interestingly, Jennifer emphasized the word “precise,” because at the end of the day she feels the liability and pressure to serve her patients. Unfortunately, with insurance companies dictating her every move, she emphasized that it stunted their ability to deliver services at a quicker pace.

On a brighter note, Jennifer and I were able to touch base on how she kept up to date with external influences, such with insurance companies.  She stressed, “You have to really keep up with readings,” whether it be daily new bulletins, memos, or articles.  Most importantly, she mentioned that she was never alone in the process.  She mentions that, over the years, you begin to become familiar and acquainted with other people in the system. For example, health insurance reps, claim directors, hospital based personnel, etc.

Looking back at all my notes, compared to the first interview, I really found myself appreciating the second interview more.  I guess it stems from the fact that we were both already acquainted with each other.  From my medical experiences, unfortunately I did not enjoy hearing much about the loads of agonizing paper work.  I have always associated paper work as being the bane of medicine.  Luckily, Jennifer and I were able to find some common humor to spark back our interests in the administrative field.  Towards the end of the interview, I was relieved to hear how maintaining current knowledge and forward movement heavily circled around a networking system.  It really solidified what we have learned in the past, concerning “becoming credible in a network of peers.”  Lastly, I was fond of the way she described the different insurances within the population as a “stratum.” As a financial conservative myself, I was truly enlighten with the evident socioeconomic difference of everyone in the nation (and not just the local community).  As a result, this interview truly influenced me to pursue the need of a much more efficient financial health care system, as a future health care administrator. However, it really then begins to bring the question of how?

Cheers,

SV.

References

Shi, L., Singh, D. (2012). Delivering healthcare in america: a systems approach. Burlington, MA. Jones & Barlett Learning, LLC.

Author: nursesarereal

My nursing professor once said that keeping a journal, over time, will allow me to see growth. In myself? I’m not sure yet. I’m hoping. I like to believe that nursing school saved my life. Maybe I’ll have some fun doing this. Cheers.

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