2 hours ago •
While patients at Winona Clinic are generally satisfied with their health care providers, they are less pleased with how long it takes to get an appointment.
According to statewide data released last week by the Minnesota Department of Health and Minnesota Community Measurement, 80 percent of surveyed patients at Winona Clinic gave their health care providers a top rating of 9 or 10 on a 10-point scale.
However, just 39 percent of respondents said they got a top level of access to care — such as timely appointments, answers to questions, and short waiting room times. That’s well below the statewide average for satisfaction with access, at 60 percent, with numbers for individual clinics across many specialties and regions ranging from 30 to 90 percent.
Winona Health CEO Rachelle Schultz said in an interview Tuesday that the access problem isn’t news to Winona Health, which has been tracking patient satisfaction for years.
As far as the most recent set of data, Schultz said it reflects national trends the industry has been anticipating: an aging population with more health care needs, a shortage of primary care physicians and health care reform.
“There’s been this kind of impending knowing, that there’s going to be this huge demand on the health care system everywhere. At the same time, when we look at workforce issues, you have the opposite thing happening,” she said.
Fewer doctors are choosing primary care, and recruiting medical school graduates can be a three-year process, Schultz said, which is not fast enough to keep up with the demand.
So while some disappointed patients tell Winona Health they’ll go elsewhere to avoid a wait, that may not do much good.
“We know the same problem exists everywhere else, and we hear that back from people,” Schultz said.
With a limited number of providers and hours in the day, the clinic has to prioritize, inconvenient as that may be.
“If you’re a patient, you want to get in right when you need to get in, and I think everybody here understands that, and I think everybody does their best, but we only have so much capacity, too,” Schultz said. “We really do try to figure out what really has to happen today versus what could happen in two weeks.”
Along with the workforce issues, Schultz said health care reform means clinics and hospitals are required to look beyond care delivered to the actual outcome of that care.
The old transactional model doesn’t work anymore, Schultz said, and it’s causing access issues because some people are using more health care than they need to, or going to the emergency room for conditions that could be addressed elsewhere.
For Winona Health, resolving those issues means taking health care outside the clinic walls, particularly for patients with chronic conditions. One example is the Community Care Network, a program that pairs health coaches with patients who frequently visit the emergency room or hospital.
In two years the program, free for patients who’ve been referred to it, has seen an 85 to 95 percent reduction in hospital stays and emergency room visits, Schultz said, reducing costs to the patients and freeing up physicians for others.
“It’s not like it’s hard to do, it’s just that in the constructs of how health care is delivered today, and what everybody thinks it should be, it’s hard to get people to think innovatively,” Schultz said.
“What we have to do is be thinking about the bigger context, of how do we keep people healthy and well, learn how to deal with conditions,” she said.
Schultz said general demographics and health care reform will continue to change what health care delivery looks like, so people looking for stability are likely to be disappointed. Generational changes are affecting the workforce in other industries, too, not just health-related ones.
But at the end of the day, while health care has changed since Winona General Hospital opened 120 years ago, it’s still health care.
“You almost have to step back and take a long-term picture of everything,” Schultz said.
“Why we do it, and what we need to do in terms of taking care — nothing changes. There’s people in need, and we take care of them. And it’s as simple as that and as complex as that.”