As I write this, I’m recalling my early days in practice. There were about 90 of us on the active medical staff of the local hospital. The Physicians’ Lounge was our place to gather. Beyond the usual banter about the stock market or last night’s high school football game, a lot of important patient care “stuff” happened there. We discussed difficult cases. We arranged referrals and consultations. We shared follow-up results. We decided on “next steps” for our patients. And we learned a lot from one another. Primary care physicians still rounded on their patients and provided the “bridge” that spanned outpatient and inpatient care. Care seemed better coordinated and our sense of professional community was pretty high.
Times have certainly changed. Driven largely by the growing financial pressures facing most physician practices (and hospitals), care is rarely delivered that way any longer. Primary care physicians have become much more focused on their clinic practices. Hospitalists provide the bulk of inpatient care. Patients increasingly rely on specialty care (especially in the face of a serious primary care shortage). And payers are more intrusive than ever. The result has been a rapid decline of our sense of community. We’re physically more detached. Paper work piles up in front of and between us. Communication among us is often lost “on hold.” Physician dissatisfaction is high.
Even more concerning is the fact that patient care delivery is also becoming more fragmented. No one seems happy.
While we can’t turn back the clock to the “good old days” in the Physicians’ lounge, what can we do to recreate community among physicians? First, we can make it easier to do the right thing. At NPN, we’ve adopted Clarity as our care coordination service in large part because it makes it easy for physicians and their staffs to collaborate on patient care and communicate more effectively about what’s clinically important, while at the same time, continuing to do the work they have to do anyway. Indeed, it’s faster, cheaper and easier to collaborate and coordinate referrals this way than the old way. And it fosters communication and community.
Using Clarity to coordinate care is one step down the road to actually organizing ourselves in a new way, remaining independent while becoming jointly accountable for all aspects of care for our patients. I’ll have more on this in my next post.
