"I think most physicians are in step with the fact that change needed to happen. "
By Harold Ambler Contributing Writer
Elaine Jones was inaugurated as the 155th president of the Rhode Island Medical Society on Sept. 27, 2013. A graduate of Smith College, Jones earned her medical degree at the Medical Univer¬sity of South Carolina and did a resi¬dency in internal medicine at Baystate Medical Center, and residency and a fellowship in neurology at Rhode Island Hospital. She is in solo private practice in Bristol and Greenville. She is a past president of the medical staff of Roger Williams Medical Center.
PBN: What kinds of neurological conditions may receive better treatment under HealthSource RI and the ACA?
JONES: Hopefully by allowing patients access to health insurance they will gain better access to the health care system in general. Patients with neurological conditions often have chronic conditions and so it is vital to have access to consistent, quality care. Therefore patients with MS, diabetic neuropathies, epilepsy, etc will be better served.
PBN: How do neurology and public health intersect in ways that a lot of lay people may not recognize?
JONES: Many neurological diseases impact society in a variety of ways. From the migraneur to the family caregiver of a demented parent, lost productivity due to missed work can have enormous repercussions for society. Neurological diseases also drain medical resources due to institutional needs of Dementia or Parkinson's patients, falls in elderly, brain or spinal cord injuries from trauma/violence.
PBN: As a public health advocate, would you say that changes in health care delivery in Rhode Island are taking place at about the right pace, or would you rather see the changes coming faster (or slower)?
JONES: This is very tricky. In some ways I wish things would change at a much faster pace. However we don't know that the changes we are implementing will have positive impacts on health or quality. The hope is that they will but the best known outcomes are on lowering costs of health care. Lower cost does not necessarily equate with better health or quality of care. So we need to move cautiously. At the same time the current system was broke and unsustainable. We needed to reign in cost and become a more efficient system. So it is vital that we got things moving. The system will have to remain nimble however and if a model or regulation isn't working in the best interest of the patient, then it needs to change. It will be important to continue to monitor and tweak things moving forward. One size will not fit all and we need to have flexibility with in the system.
PBN: In terms of your role as president of the Rhode Island Medical Society, how much consensus exists within the society regarding the implementation of the ACA?
JONES: I think most physicians are in step with the fact that change needed to happen. Many providers are frustrated with the current system and look forward to improvements. However change is always difficult. The growing regulations and intrusions between patients and providers is frustrating. Most of us want to be part of the process to assure that our practices are functioning at the highest levels possible and our patients are receiving the best care possible. I have been impressed with the involvement of the provider community in the implementation process. We all want this to work and realize that we and our patients must have a voice at the table. Otherwise things might be too focused on cheaper care and not on the quality required. Having said that, there are significant areas that are not addressed by the ACA, most notably malpractice reform. Medical malpractice has a significant impact on cost of health care but is ignored completely by the ACA.
PBN: What has been your most satisfying experience as a medical doctor?
JONES: My favorite thing about being a doctor is the interaction with patients. I love getting to know them and doing what I can to relieve their worries or to ease their sufferings. In neurology we rarely have a cure so we focus on quality of life and there is a lot we can do to improve quality. I find it very rewarding to help people in this way. Just helping them to understand what is going on can be reassuring. As I spend more time filing paperwork and checking boxes on a computer I struggle to maintain this personal contact with my patients. It would not be a rewarding profession without that.