Complexity in the Health Care System

Written by Jeanette R. Harrison, MPH

When many people think about the health care system, they often think about their doctor's office and the local hospital.  However, there are many, many components to the health care system in the United States. The different aspects of health care range from private practices to hospitals to insurance carriers to medical equipment providers.  There are many companies involving health care that people really do not think about automatically.  Each of these areas may directly or indirectly affect a patient's care or health care experience.

I will illustrate this using an example of a patient visiting their primary care physician.  The patient goes to the provider's office, which is referred to as a clinic, or physician practice.  While there, the patient goes to an exam room and sits on an exam bed.  This is another area of health care, medical equipment.  The provider examines the patient and uses medical supplies. These supplies are created and provided specifically for clinics or hospitals.  The provider then looks up the patient's medical information on the computer, known as an electronic medical record (EMR).

The electronic medical record is usually provided by an outside health information technology company, although some organizations do create their own electronic medical records.  The medical records are entered into the electronic medical record sometimes by medical transcriptionists.  There are companies that solely provide medical transcription services.  In order to have that information, a doctor dictates into a machine specifically designed for medical transcription.  This is a medical office equipment company.  Now, let's imagine that the provider ordered blood to be drawn.  This is completed by a laboratory services organization.

Of course, the patient needs to be billed for their various services.  This billing may be completed by the physician practice or by a billing services company. Insurance companies and/or Medicare and Medicaid are involved in the billing cycle.  As a result, the state government and federal government are also involved in health care services.  If the clinic is a public health facility, then the city government or county government may operate it.

Now, take a moment to look back at the highlighted terms.  Although this is a very simple and broad example, at least 15 different types of health care organizations were involved in this one patient's visit.  As you can see, it takes many different health care entities to provide services to patients beyond the provider and the clinic.