Dr. Roger Olade is a highly respected physician who has worked in medicine for over two decades. He has come across virtually every disease and countless disorders during his career. While he focuses on internal medicine, he is also particularly interested in critical care. Here, he discusses what the key elements of this type of medicine are.
Roger Olade on Critical Care
Critical care is the field of medicine that focuses on those who have a condition, be that a disease, disorder, or injury, that will impair the functioning of at least one internal vital organ to the point that death is likely if it is not addressed. Critical care concerns itself less with pain medicine, therefore, and more with ensuring the patient’s vital organs continue to function. Some examples of conditions that must be treated in critical care include:
- Circulatory failure.
- Central nervous system failure.
- Respiratory, metabolic, hepatic, and/or renal failure.
One of the reasons why Dr. Olade is so interested in the field of critical care is because it requires the health care team to be able to make high intensity interventions and highly complex decisions on the spot. Unfortunately, health care facilities also have to bill their procedures properly and this can be quite complex when someone is in critical care, because it must be demonstrated that any work completed was to ensure the patient would no longer be in critical condition. For instance, stabilizing the neck and back after a fall injury is considered critical care. Realigning the spine after the patient is stable, on the other hand, is not.
Particularly in the era of criticism of the Affordable Care Act, health care facilities and staff alike are nervous about delivering the appropriate care not in terms of the survival of the patient, but rather in relation to billing. For instance, when no hospital beds are available elsewhere, patients may be admitted to critical care wards but should not be billed as such. Similarly, nursing observation and frequent vital sign observations are not classed as critical care.
The lines between critical care and concurrent care are becoming increasingly blurry as a result of bureaucracy and red tape, something that fascinates Roger Olade. It fascinates him because of the level of stress that these situations add onto those who deliver critical care. When a health care professional is busy saving someone’s life, they already have to make quick fire, on the spot decisions and they should not have to add complications such as billing and insurance issues to that equation. However, the current health care administration is such that they are nearly forced to do so anyway.
According to Dr. Olade, it is vital, therefore, that a clear definition of what critical care is – and what it isn’t – is provided to all health care facilities across the country. Once everybody knows which actions are classified as providing critical care, there will also be more clarity on the administrative issues associated with this.