The survey sponsored by the Blue Shield of California Foundation (which supports KHN's reporting in California) canvassed 1,500 people and found only half of those earning below 200 percent of the federal poverty line felt the quality of their care was excellent or good. Satisfaction increased to 70 percent for people whose incomes exceeded the 200 percent FPL.
It suggests the reason for the disparity isn't income per se, but the quality of relationship between the patients and their caregivers. Low-income people often get their care at resource-strapped community clinics and emergency rooms from a turn-style of time-starved providers who make them feel disconnected to the facilities and their staff.
The findings support a move toward the so-called patient-centered medical home, a model of primary care focused on prevention and treating patients with teams of doctors, nurses and other support staff. The idea is to promote better and more consistent communication with low-income patients to improve their satisfaction and care.
No doubt better customer service is good for every consumer, wealthy or not. But is it the solution to our growing healthcare disparities? From the study, it's clearly the solution healthcare providers prefer and the best for their bottom lines.
“It comes down to customer service,” said Peter Long, the president and CEO of the foundation. “Instead of worrying about problems that could take years to fix, let’s start working today on communication, information and trust.”
The patient-centered, team-based approach is cheaper — and possibly more effective long-term — than recruiting extra doctors or investing in high-tech gadgets, Long said.
It's also possible the reverse could be true: Without correcting systemic problems, the cheap fix may be another bandaid.