There's no magic wand to making patient-centered care a reality within a medical practice, failing to make that transition can have a negative impact on the practice's bottom line.
The results of a recent survey indicate that physicians don’t do enough to consider their patients’ needs prior to prescribing treatment. The survey by Wiser Together, which offers platforms for patient-centered care, updates the Patient-Centered Care Index (PCCI), a nationwide, quarterly survey of 2,500 patients who have received physician care within the last six months.
The survey’s latest results place the PCCI at 3.46 on a 5.0 scale. According to Wiser Together, a score of at least 4.0 is required for patients to agree that physicians are effective at patient-centered care.
Patty Skolnik, the founder of Citizens for Patient Safety, is not surprised by the results, unfortunately.
“It takes a lot of time and effort to transition from a traditional model to one of patient-centered care,” Skolnik says.
Nevertheless, failing to make that transition can have a negative impact on a medical practice’s bottom line.
Skolnik says that there’s no magic wand to making patient-centered care a reality within a medical practice, but notes that a key ingredient to success is a total team effort. Everyone, she says, needs to be on the same page — including the patient.
“It takes the doctor, and if they have a PA, and I think it even starts with the receptionist,” Skolnik says. “The whole staff has to be on board with this. And then it takes the patient’s willingness. We can give them the information, but it has to be their decision as to what they want to do going forward.”
Skolnik acknowledges that achieving patient buy-in is often no easy task, and she recognizes that physicians and their medical practice staff can often become frustrated during the process. But, she believes the good that comes from achieving that buy-in — a fully active patient with a high level of willingness, and the skills, health literacy, making decisions concerning their diagnosis and medications — is worth the cost.
“It comes down to talking about time and money,” Skolnik says. “And I understand that it’s going to cost a little more up front, but we live in a very social media world. And so I think the positive is that in the long run [physicians] are going to get more patients because they’re going to have better outcomes, they’re going to have fewer medication errors, better quality and value for their service. They’ll have positive word of mouth and reputation, and those are things that can’t be bought.”
Accessibility and visibility
Christine Meyer, MD, has run her own internal medicine practice in Exton, Pa., since December 2004. She and her team have been running a patient-centered medical practice since day one — even if that wasn’t the official term nine years ago when the practice opened its doors.
Meyer agrees with Skolnik that running a patient-centered medical practice is a team effort, from the physician down to the receptionist, and costs money — but the results are well worth it.
“I have a really high payroll because some of the people I employ are really high-quality people that have been with me for a long time,” Meyer explains. “I’ve been criticized by people who are so-called ‘in the know’ about medical practice: ‘why would you pay this person this much money just to answer your phone, or just to be your triage nurse?’ Because they have fostered relationships with people that you cannot put a price tag on. And turnover in staff is one thing that detracts so much from patient-centered care.”
Meyer is also visible and accessible — two huge ingredients to delivering patient-centered care.
The practice has a Facebook page, and Meyer writes a regular blog that she says makes her a very effective physician because “patients really do respond to those of us who are in their trenches, who are in their grocery stores, at their sporting events, and living life like we all do.”
Plus, Meyer’s office is open from 7 a.m. to 8:30 p.m. several days a week, and her cell phone number is made public to every single patient in the practice. It’s on her business card and her website, and patients are encouraged to text or phone if they’re having a problem. Patients are also encouraged to email for a referral, for a prescription or for a question.
And Meyer and her staff do all these things without charging patients, unlike other models she cited where patients can email their doctor as long as they pay a monthly fee for the privilege.
“I think that free accessibility in this day and age is so important to patients,” Meyer says. “Because not everybody has time to sit on a phone and go through a menu and wait 20 minutes to get to a human being. Why is our industry so backwards in that? So, I think one huge thing that physicians could do better in the patient-centered medical practice is just improve accessibility, and do so without assigning it a dollar sign.”