'Woefully lacking' county health system

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Chicago Tribune Commentary
By Dr. Elizabeth Jacobs, Senior Attending Physician, Stroger Hospital
October 8, 2007

Thank you to the Tribune Editorial Page for expressing what many of us "in the trenches" know about Cook County governance. It is woefully lacking. I was astounded by President Stroger's response ("Stroger defends his administration's work," Commentary, Oct. 3) in naming the increased number of screening rooms to the Ambulatory Screening Clinic, reduced pharmacy wait times, and $3 dollar prescription co-pays as "achievements."

As our patients will tell you, they are far from it.

Here is what Todd Stroger didn't tell you:
-- The additional rooms added to the ASC pale in comparison to the seven ambulatory clinics closed by the administration and the hundreds of visits that they provided to the people of Cook County each year. He did not elaborate on the fact that so many of the patients who lost their "clinic home" must come to the ASC to get the care and prescriptions they need because they cannot find out if their primary doctor was moved to another clinic or fired. He also failed to mention how the ASC has reduced hours and is short-staffed because so many physicians were fired during the budget cuts or have quit because of poor working conditions and job insecurity, leaving it inadequately staffed. So much for the addition of a few rooms.

-- The pharmacies are as packed as ever and one of the reasons is the $3 co-pay. It may take less time to get your prescription in number of days (it used to be seven from prescription drop-off to pick up), but patients spend hours in line to have their financial and insurance status reviewed before they can pay and pick up their prescriptions.

I recently had a patient tell me about how she spent a whole day working to get a needed diabetic medicine. She was told in the hospital pharmacy that she had to go the Fantus pharmacy. When she got to the Fantus pharmacy, she waited in line only to be told she had to go back to the hospital to be screened financially and to pay her co-pay. When she got back to the hospital she waited in another line for more than an hour just to be told that the information was wrong and she had to go back to the Fantus pharmacy, wait in the financial screening line there, and then pick the prescription up. Is this $3 really worth this patient's time and the county's resources when we can't even bill Medicaid and Medicare for the big ticket costs?

I have trained and worked in many health care systems and have never seen one so inefficient and poorly managed. It is not something that Mr. Stroger should be proud of.

I wholeheartedly agree with this page: The Cook County Bureau of Health needs new governance.

It must be independent of the Cook County Board, and it needs to happen before we lose any more ground in our ability to care for the un- and underinsured in Cook County.