Over 59 years as a health consumer, I've experienced a multitude of
gatekeeping types, some excellent, some not so excellent. The best was an
HMO, where even the Nurse Practitioners were excellent as gatekeepers,
taking the needs of the patient in mind.
However, the worst two experiences I have had were getting young
women on the phone who probably had high school diplomas, who didn't even
understand (or know how to spell) the condition I was talking about. I had
had to make the request for referral myself in these health organizations.
In one or both of these situations I was turned down. In both, I appealed
and finally spoke to an MD. In the case of wanting a second opinion for a
cholecystectomy, I won my appeal. I frankly don't remember the outcome of
the second.
Gatekeepers should be medical personnel, either advance practice RN's
or MD's, no less!
Rapid Response:
Gatekeeping from a patient's POV
Over 59 years as a health consumer, I've experienced a multitude of
gatekeeping types, some excellent, some not so excellent. The best was an
HMO, where even the Nurse Practitioners were excellent as gatekeepers,
taking the needs of the patient in mind.
However, the worst two experiences I have had were getting young
women on the phone who probably had high school diplomas, who didn't even
understand (or know how to spell) the condition I was talking about. I had
had to make the request for referral myself in these health organizations.
In one or both of these situations I was turned down. In both, I appealed
and finally spoke to an MD. In the case of wanting a second opinion for a
cholecystectomy, I won my appeal. I frankly don't remember the outcome of
the second.
Gatekeepers should be medical personnel, either advance practice RN's
or MD's, no less!
Competing interests:
None declared
Competing interests: No competing interests