Thursday, August 4, 2016

It Is Not What You Say, It Is What You Do

Marketing tag lines are pervasive in our society. If a concept is “in vogue,” organizations want you to believe “oh yes, we do that, too.” A good example of this in healthcare at the present is the term “patient-centered.”  The consumer should be wary of healthcare organizations who are using this term and they should check to see if the organization is really putting them in the center of what they do or are they just saying it.

To become patient-centered, you have to start by listening to what it is that the patient wants. Most patients want the care to be accessible when they need it. This is the reason that urgent care centers have sprung up.  Primary care offices were not open or did not have appointments when the patient had a need. Most patients, especially those with chronic disease, also want care from clinicians who they know and respect. They don’t want to have to keep introducing their problems to new people who will have a different treatment plan. Patients don’t want their time wasted. They want fast, but, first and foremost, they want the correct evidence-based care because they want to get well. Most patients would agree that getting an antibiotic that they really shouldn’t take just so the provider can get them out of the office faster is not an example of being patient-centered.

So what has GBMC been doing to be patient-centered?

A good example of true patient-centeredness is in our advanced primary care practices, our Patient-Centered Medical Homes. For these practices, it is no longer about the visit. It is about a relationship between a physician or advanced practitioner and a patient and a promise to that patient to help him or her stay well or get well when they are sick. The team is available when the patient has an acute need, but, moreover, the team studies the patient’s health and preventive care needs at regular intervals and works with the patient to assure that they get what they need. A good example of this is our work to assure that everyone who should have colorectal cancer screening gets it. We don’t wait for the patient to make an appointment. If we see that the patient is due for a colonoscopy, we contact the patient to help get it done.

The Medical Homes have significantly improved their availability. They are open Monday through Friday 7AM to 7PM and have Saturday and Sunday hours. As a group, they have provided office hours on major holidays as well. It is much easier to close at 5PM and not be open on weekends and holidays….but that isn’t patient-centered nor is it patient-centered to send patients to emergency departments for non-emergencies or to urgent care centers for acute care because it isn’t convenient for the primary care offices to be open.
The Medical Home is a model that emphasizes care and communication and transforms primary care into ‘what patients want it to be’ – a partnership between patients and their doctors to improve health, to improve the patient’s satisfaction with the way the care is delivered and to reduce cost. So, at GBMC we are well on our way towards our vision and we are not just talking patient-centeredness…we are doing it!

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