The Winner’s Circle in Healthcare: How to Avoid Political Paralysis

By Hank Duffy, President & CEO

The political circus around healthcare has dawned, and it’s hard not to get wrapped up in the chaos, confusion and contradictory advice. While the knee-jerk reaction is to become paralyzed and to take a wait-and-see approach, this is wrong.

Instead, it is the right time to focus on what will make care-delivery organizations more effective in managing clinical quality and cost and improving the patient experience.

There are two “no brainer” areas where near-term focus will only enhance competitiveness:

  • Improving how the care delivery network operates
  • Strengthening the primary care component

Improving how the network operates involves more change management than most physicians enjoy, but it is essential to managing clinical quality and bringing down cost. The network should be the “Care Manager.” The quiz to assess how well your network is operating includes:

  • Do we have reliable transitions of care, particularly from inpatient to outpatient?
  • Do we regularly and reliable coordinate care among PCPs and specialists?
  • Are the referral systems “user friendly” and supporting two-way communication?
  • Are we providing data on the effectiveness of care coordination (i.e. readmits, access times, clinical outliers, etc.)?

When it comes to strengthening the primary care component, the obvious question is if there are enough PCPs in the right locations. But an equally important question to be addressed when it comes to keeping, attracting and incenting PCPs is: Are we creating an environment that is a joy to practice in?

Going back to the research done by the Annals of Family Medicine, Inc.’s publication In Search of Joy in Practice: A Report of 23 High-Functioning Primary Care Practices1, there are at least five tests of a practice that is “joyful”:

  1. Proactive planned care with pre-visit planning and pre-visit laboratory tests
  2. Sharing clinical care among a team with expanded rooming protocols, standing orders and panel management
  3. Sharing clerical tasks with collaborative documentation (scribing), non-physician order entry and streamlined prescription management
  4. Improving communication by verbal messaging and in-box management
  5. Improving team functioning through co-location, team meetings and work-flow mapping

Getting care delivery networks fully operational with a world-class primary care provider experience is where the healthcare winners will stay focused in this tumulus time.

1 2013 Annals of Family Medicine, Inc.;In Search of Joy in Practice: A Report of 23 High-Functioning Primary Care Practices; Christine A. Sinsky, MD, Rachel Willard-Grace, MPH, Andrew M. Schutzbank, MD, Thomas A. Sinsky, MD, David Margolius, MD and Thomas Bodenheimer, MD2