Friday, January 11, 2013

Getting In to See Your Doctor and Her Team


I spend a lot of time with groups of people talking about the need to redesign our healthcare system.  The one topic that always gets people’s attention is the issue of hours of operation.  People get very frustrated when they have a healthcare need and they can’t get in to see their physician or nurse practitioner. 

So I am delighted to report about the work of Greater Baltimore Medical Associates (GBMA) and its primary care practices and specialist practices at increasing access to care. To help reach our vision of providing the care that we would want for our own loved ones every time, we have been working to make it easier to get in to be seen when you need to be seen.  The number one strategy for this is increasing hours of operation. Through the hard work of GBMA Medical Director Mark Lamos, M.D. and Chief Operating Officer Ben Beres and with the leadership of physicians at each site and the practice managers, we have significantly increased the probability that a patient can get in to see us when he or she needs to.

Back in 2010, GBMA physician offices were open Monday through Friday, 9 am – 5 pm – which admittedly is often not very convenient for many people and often not when illness and sickness strikes. Now, all of the GBMA Primary Care offices have extended office hours Monday through Friday between 7 a.m. and 7 p.m - patients should contact their individual practice for their specific hours or check the GBMA website. In addition, our Hunt Valley office has already started Saturday hours between 9 a.m. and 1 p.m. and over the next several months all of our Primary Care sites will be open on Saturdays. 

The underpinning of our strategy is the Patient Centered Medical Home, which is centered on an ongoing relationship between the medical care team and the patient such that there is joint decision-making and joint ownership of the patients’ health. In order for this joint ownership to work, the physician and her team need to be available when the patient has a need. The team has to share the responsibility and not act like it is a surprise when the patient calls and needs to be seen. No longer is it ok to use the Emergency Department as the pathway of least resistance. The ED was made for emergencies, and it should not be encumbered with fixing the problems of a poorly designed primary care system. I am so proud of our GBMA teams that they are redesigning to get to better health and better care at lower cost. Their redesigned system is not perfect but is surely a more joyful place to work than the old model.

And we now have the evidence that our patients appreciate the redesigned system! The control chart below shows the monthly improvement on our patient satisfaction survey on the question “How easy is it for you to get an appointment when you need it?” Our score over the last two months has reached an all time high!



Let me thank all of our GBMA people for this great work. It is our intention to continually increase our hours of operation to better meet the needs of the people we serve and to continually move from fragmented care to seamless care. Watch us in 2013!

10 comments:

  1. Dr. Chessare, Dr. Lamos, Mr. Beres, and practice managers: I feel that it is wonderful that GBMA is able to provide better access to their healthcare team, however forcing this upon staff that was hired for regular business hours is not acceptable. Our focus is to treat every patient with the care we would want for our own loved ones, however, somehow GBMC is losing focus on the people that help make this happen. YOUR EMPLOYEES. We would love to care for our patients as we would for our own family, but this is hard to do when we cannot be there to even take care of our families. Please keep your employees and their families in mind during all decisions and do not force new hours upon those who simply cannot work them due to their own families needs.

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    1. Thanks for the comment, Anonymous. No one should work more hours than they were before. They may have to take turns working different hours. As we hire new people, we will look for folks who either want to work the "off hours" or have flexibility in their schedule. We are working hard to accomodate everyone's needs.

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  2. Dr Chessare - Wait until Obama gets his claws in. You may rethink how healthcare is really going to go. By the way, I'm middle class and I had a very rich amount of taxes taken out of this last pay. Many of my low information coworkers were shocked. They thought only the "rich" were going to be taxed. What a joke.

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  3. I am delighted to read about this and am excited that it is happening. I have been sick with flu like symptoms for about 6 weeks now and have had to visit the Emergency Department 3 times because my doctor has been on an extended vacation (which I am sure is well deserved), but I could not get an appointment with the doctor that was filling in.

    Hopefully, the extended hours will help in situations such as this.

    Thank you!

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    1. Is your primary care doctor employed by GBMA or is he or she in private practice? If your primary care doctor is employed, then you should have been offered an appointment with one of his or her colleagues. We cannot expect our physicians or nurse practitioners to work more than full time hours, however, a teammate must always be available.

      If your primary care doctor is not employed by GBMC, it appears that he or she is using the Emergency Department as a "pathway of least resistance". He or she absolutely must take a vacation but the system must be designed to accomodate that without putting the patient at risk.

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  4. I had significant spinal surgery at G.B.M.C, and DR.REGINALD DAVIS is the best of the best, and the entire staff at G.B.M.C treated me and my family with the utmost respect & patience. G.B.M.C as a whole is a TOP notch facility.

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  5. I am very grateful that my physician has late hours, and my husband is thrilled. He works in the D.C. area and in the past would have to use a half (or even a whole) vacation day to be able to see a doctor for a routine visit. He no longer has to dip into benefit time to do that. Thank you and your team for the work that's gone into getting this initiative accomplished!

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  6. This is not adequate with this flu season upon us. My husband whom is diabetic had blood sugars in 250's and suffering with Sinus infection symptoms is still waiting for his appt on the 25th. He could not wait any longer and went to our former family practice physician which we will be paying an arm and leg for because GBMA could not fit him in anywhere any earlier. This makes me wonder if we made a good decision?

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    1. If you would like to send me or Ben Beres an email offline we will look into this. In the meantime, please accept my apology. This is not acceptable as you present it.

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  7. As a current employee I think the extended hours are great! The early morning and afternoon slots are always filled first. Now I fell like I won't have to take off from work to see my physician. This change coupled with not having a co-pay is awesome.

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