May 30, 2023

The when and how of Urgent Care

The supply chain crisis threatening health care access has had a unique impact on Urgent Care. Plan ahead to make the most of this treatment option.

Let's ask Jo! She'll know! (No. 4 - Urgent Care)


Jo has incorporated her unique expertise in demographics, the health care workforce and health literacy into an innovative initiative, Bridges to Health Care Access. Visit the "BRIDGES" page here to learn more.

May 23, 2023

The dreaded request for a second opinion

Have you or a loved one ever received a diagnosis that really rocked your world, and wondered if a second opinion was in order? But then there's all the awkwardness of suggesting your doctor made a big mistake . . .  

Take heart, because the best reason to get a second opinion also offers a graceful approach.  

When and how to ask for a second opinion


Jo has incorporated her unique expertise in demographics, the health care workforce and health literacy into an innovative initiative, Bridges to Health Care Access. Visit the "BRIDGES" page here to learn more.

May 18, 2023

Time to make friends with medical technology

The U.S. Department of Health and Human Services mandated health care providers to make Electronic Health Information (EHI) accessible to patients immediately upon creation, as of October 2022. That has had definite benefits, but also potential risks . . .

HHS Rule Mandating EHI Access


Jo has incorporated her unique expertise in demographics, the health care workforce and health literacy into an innovative initiative, Bridges to Health Care Access. Visit the "BRIDGES" page here to learn more.

May 12, 2023

This is not good news for Iowans

It saddens me to report that the State of Iowa has slipped out of the Top Ten States With the Highest Median Salary for Physicians (resource courtesy of Becker's Hospital Review)Unless we can figure out how to add mountains or an ocean to our landscape, we will continue to struggle in attracting and keeping top health care professionals. It's another negative indicator of Iowans' ability to access health care where, when and how they need it. 


Jo has incorporated her unique expertise in demographics, the health care workforce and health literacy into an innovative initiative, Bridges to Health Care Access. Visit the "BRIDGES" page here to learn more.

April 20, 2023

Bridges to Health Care Access

Bridges to Health Care Access

Health care’s supply chain is broken. So broken. Demands are escalating, resources are dwindling and leadership is failing. And with each passing day, we recognize more signs of this crisis of access: Can't get an appointment with that specialist? Your primary care provider is suddenly gone? The procedure you need is postponed--again? It's time to ask: 

"Where will I be when the music stops?"

Jo has now incorporated her unique expertise in demographics, the health care workforce and health literacy into an innovative initiative, Bridges to Health Care Access. In lively presentations, she reveals facts—not speculation—on ledership's failure to acknowledge and prepare for this looming crisis. Then she shares her plan for individuals and “communities” to access health care and achieve best health outcomes. 

Visit the "BRIDGES" page to learn how you can achieve best health outcomes in spite of demographics, shortages and systemic failures. 

January 23, 2023

The end of the Public Health Emergency is bad news for many

Enrollment in Medicaid and the CHIP program (health care for children) increased 28 percent throughout the pandemic. There are now 91 million Americans enrolled in these health care programs as the requirement to prove eligibility has been suspended throughout the Public Health Emergency (PHE). But that is about to come to an end.

Once the PHE is no longer in effect, it is estimated that between 5 and 14 million will lose their health care coverage during the "winding down" of this suspension. Much will depend on how efficiently each state prepares for and manages the paperwork and bureaucracy that these massive redeterminations require. 

KFF's "10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision"

But hey, it must not be a potential health care access crisis for a lot of people or you would have heard about it already, right? 

December 19, 2022

Is the health care business model sustainable?

The occupation of "travel nurse" has been around for a very long time, but the workforce has grown exponentially since health care labor shortages began squeezing providers to choose between contract employees or shuttered wings. (And that was well before Covid-19 arrived.)

In 2022, Iowa lawmakers responded to the pleas of hospitals and care facilities by making it more cumbersome and expensive for staffing agencies to do business in Iowa. How has that worked? Well, our providers are still relying on the costly option of travel nurses. How costly is it? 

Beckers' Hospital Review is sharing the statistics. In Iowa, travel nurses make 254% of what their employee/co-workers earn.  

Beckers' Report:  Travel Nurse vs. Employee Pay

I guess when you're 46th in the nation for nurses' pay, it's not surprising that you're third for travel nurses' pay. 

Sometimes it is about the money. Think of it as hazard pay.

October 24, 2022

How can you protect yourself from a cyberattack?

MercyOne in the Des Moines metro is part of the CommonSpirit health care system. For the past three weeks, facilities and providers in 21 states have been directly impacted by a crippling ransomware attack on their electronic health information (EHI). Now the dust is settling and EHI is coming back online (hopefully, with minimal damage to patients' medical records).

Let's take a few moments to better understand the cyber threats swirling about us and, as importantly, to appreciate the steps we can take as health care consumers and advocates to minimize harm and continue to achieve best health outcomes--in spite of a cyberattack.  My op-ed in the Des Moines Register says it all:


October 15, 2022

This attack is much too close to home

Of course, I know there are cyber security risks swirling about 24/7, but it's all too vivid when it hits a health care provider in my own backyard. Last week, MercyOne, a part of the CommonSpirit Health family, was hit by ransomware. For many Iowans, it has meant delayed diagnostic tests, cancelled surgeries and potential harm from the lack of accessible electronic health information.

We have come to take for granted the wonder of having our glucose monitored remotely, doctors who can review our last test results with the click of a key and online appointment scheduling. Poof, and they were gone.

There are some simple action steps that can make your journey as a health care consumer or advocate safer and more likely to result in best health outcomes, even in the event of a techno catastrophe. Please take time to learn and practice those strategies for self-preservation.

September 25, 2022

No one to answer 911 calls? Fuggedaboudit.

In response to the Des Moines Register's two-part story on the shortage of emergency response workers throughout Iowa, I wrote this Letter to the Editor, published September 25, 2022. Not that anyone's listening . . .  

EMS troubles highlight deeper problems

Re: "When you call 911, will an ambulance come in time?" (Sept. 18): For those who claim Iowa’s lack of emergency services is just another crisis that needs some money thrown at it, chew on these facts (not opinions):

At the same time Iowa’s EMS demands grow because of the demographics of aging and chronic illness, the number of Iowans aged 18 to 64 is shrinking.

A convoluted and expensive process to declare EMS “essential” is moot for the nearly 1,000 Iowa towns that don't even have the funds to train willing volunteers, which are 75% of the EMS workforce.

The conscious denial of Iowa’s crisis of health care access by those who are paid to know better is not only deplorable, it is downright life-threatening. 

- Jo Kline, West Des Moines

September 13, 2022

On the small chance a politician is listening

Earth to fearless leaders: Eight of every ten American adults are somewhat concerned they can't access quality and timely health care. Half are extremely concerned about that. And yet, we have candidates who no longer consider "health care" an issue that even merits a place on their agenda. Deja vu all over again. 

"Americans give health care system failing marks"

August 8, 2022

What are they waiting for?

The Inflation Reduction Act cap on Medicare drug costs doesn't take effect until 2025.

That makes sense. Not.

July 14, 2022

We need more beach umbrellas!

It's like watching a tsunami on the horizon while Iowa's policy makers call for more beach umbrellas. The Iowa leadership and legislature continue to deny Iowa is facing a devastating health care worker shortage in the near--and distant--future. A good example is the new program to fund 12 psychiatric residencies at the University of Iowa:

Jo's 7-14-2022 Letter to the Editor 

We're going to spend $1,200,000 annually on these psychiatric residencies, when we know (or at least some of us know) that two thirds of our graduating residents leave Iowa to practice medicine. As for our fellow states, are we generous, or what?

It would be super cool if this crisis of access would take care of itself without policy makers stepping up to address a life-limiting threat to Iowans' health. It won't. 

July 6, 2022

One step forward, two steps back

The dust has settled on the 2021-2022 Iowa legislative session and we can now see how the cause of health care access for Iowans was furthered. One bill I watched closely called for funding more psychiatric residencies, intended to address the mental health needs of Iowans.

So the good news is that there will be an additional 12 psychiatric residencies at the University of Iowa Hospitals. Preference will be given to Iowa residents who got their undergraduate or medical degree at an Iowa school. All good, right? 

Not so much. Less than one fourth of Iowa's medical school graduates stay in Iowa, and only one third of those who complete a medical residency in Iowa end up practicing here. (FYI, data is from the Association of American Medical Schools, because Iowa's medical schools don't even track this.) This new law contains no incentives or mandatory requirements to stick around after the residency. $1,200,000 per year will be spent on these scarce residency slots. 

I cannot understand why policy makers refuse to acknowledge the brain drain of Iowa's medical professionals that further threatens Iowans' access to care. It eludes me.

June 15, 2022

It's not just about leaving a sponge behind

They're called "never events," the medical errors we hope never occur, like operating on the wrong patient or leaving a sponge behind after surgery. Nevertheless, they do happen about 4,000 times a year. But they're not really what you should be worrying about.

HHS has just released a study verifying that one fourth of Medicare patients are harmed while being hospitalized. Those medical errors are called "hospital acquired conditions" and almost half are preventable. Falls, infections, misdiagnoses, faulty medicating. All result in patients who now have a medical ailment they didn't have when they were admitted. Many do not survive to be discharged or are permanently impaired. 

Please consider how you can be a more engaged--and safe--patient. Then start making self-advocacy a priority in your own health care journey.