Orphan patient
Encyclopedia
In health care
, an orphan patient is a patient
who has been "lost" within the system or has no primary provider
overseeing their care.
Usually, the primary provider is a general practitioner
who takes care of some of the basic health needs and then refers to a specialist for complicated medical problems. Thus, orphan patients are sometimes referred to as "no-family-doctor" patients. The view from insiders and health care providers is that orphan patients tend to receive inferior care compared to those who have a "gatekeeper" coordinating the medicine.
The Wordspy entry for this phrase is as follows http://www.wordspy.com/words/orphanpatient.asp:
The orphan patient problem has only been recognized in the media recently. However, there at least one older New England Journal of Medicine
that used the phrase as far back as 1988:
N Engl J Med. 1988 Mar 10;318(10):646.
The orphan patient.
Shelley WB, Shelley ED.
Publication Types: Letter
PMID: 3344016
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
, an orphan patient is a patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....
who has been "lost" within the system or has no primary provider
Primary care physician
A primary care physician, or PCP, is a physician/medical doctor who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis....
overseeing their care.
Usually, the primary provider is a general practitioner
General practitioner
A general practitioner is a medical practitioner who treats acute and chronic illnesses and provides preventive care and health education for all ages and both sexes. They have particular skills in treating people with multiple health issues and comorbidities...
who takes care of some of the basic health needs and then refers to a specialist for complicated medical problems. Thus, orphan patients are sometimes referred to as "no-family-doctor" patients. The view from insiders and health care providers is that orphan patients tend to receive inferior care compared to those who have a "gatekeeper" coordinating the medicine.
The Wordspy entry for this phrase is as follows http://www.wordspy.com/words/orphanpatient.asp:
Contributing factors
There are multiple factors that are contributing to the orphan patient problem in North America. Some of them include:- problems maintaining a supply of qualified health practitioners
- providing access to them where and when they are needed most
- a growing population of patients
- an aging population of patients
- a sicker population of patients (particularly with diabetes and obesity being rampant in North America)
- a more "medicalized" population of patients (expectations for medical care are higher than ever, and we have more defined diseases to treat)
- increasing complexity of treatments for the diseases we have always known about (standard-of-care treatment for heart attack is much more labour-intensive now than it was even a decade ago)
The orphan patient problem has only been recognized in the media recently. However, there at least one older New England Journal of Medicine
New England Journal of Medicine
The New England Journal of Medicine is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It describes itself as the oldest continuously published medical journal in the world.-History:...
that used the phrase as far back as 1988:
N Engl J Med. 1988 Mar 10;318(10):646.
The orphan patient.
Shelley WB, Shelley ED.
Publication Types: Letter
PMID: 3344016
Solutions
Solutions to the orphan patient problem are complex, as expected due to its multifactorial origins. It is not possible to decrease the population. It is not easy to increase the number of physicians and other health care providers available, as the time to train them tends to be long. Some of the temporary solutions have involved changing the way that health care is provided by:- making greater use of alternative health care providers such as nurse practitionerNurse practitionerA Nurse Practitioner is an Advanced practice registered nurse who has completed graduate-level education . Additional APRN roles include the Certified Registered Nurse Anesthetist s, CNMs, and CNSs...
s, hospitalists and TelehealthTelehealthTelehealth is the delivery of health-related services and information via telecommunications technologies. Telehealth could be as simple as two health professionals discussing a case over the telephone or as sophisticated as doing robotic surgery between facilities at different ends of the...
-style public information services. - using technological assists such as electronic medical recordElectronic medical recordAn electronic medical record is a computerized medical record created in an organization that delivers care, such as a hospital or physician's office...
s and telemedicineTelemedicineTelemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities...
to make the existing health care providers more efficient. - implementing wider and more effective public healthPublic healthPublic health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
initiatives such as smoking cessationSmoking cessationSmoking cessation is the process of discontinuing the practice of inhaling a smoked substance. This article focuses exclusively on cessation of tobacco smoking; however, the methods described may apply to cessation of smoking other substances that can be difficult to stop using due to the...
and fitnessPhysical fitnessPhysical fitness comprises two related concepts: general fitness , and specific fitness...
programs in order to decrease the burden of illness on a community. Community smoking banSmoking banSmoking bans are public policies, including criminal laws and occupational safety and health regulations, which prohibit tobacco smoking in workplaces and/or other public spaces...
s and seatbelt regulations are political interventions that are sometimes spearheaded by medical professionals but can be implemented without their involvement.