In the great corporation that is the U.S. healthcare system, doctors are relegated to mere cogs in the wheel that make the machine function. Patients are now chess pieces, or prizes to be won, on the board game of life and death. Healthcare remains one of the biggest sectors of our economy and everyone wants a piece of that pie.
Doctors are not satisfied under this structure because we are pressured to do more and more with less and less. Pressure comes from employer executives as well as third-party influences. But while doctors strive to do the best, patients are the ones who are truly losing and their health is no longer the top concern of many in the healthcare community.
How can we return our practices to patient-centricity?
• Learn to say no. Examine your practice and who is controlling it. Is there an insurance company that makes it the hardest to get diagnostic tests and medications covered for patients? Drop the ones that make you and your patients miserable. In fact, many doctors decided to drop insurances all together and have evolved to Direct Primary Care (DPC).
• Fight. Doctors spend so much time trying to get prior authorizations and/or appealing denied care. It is all too easy to go for the lesser alternative that may not be the best for the patient. We should always strive to give our patients the best.
• Make eye contact. Many patients now complain that doctors are so into their EHR that they don't look at them. Unfortunately, much of this has to do with regulations that require us to record certain metrics. Trust me, doctors hate this more than anyone else. But, we need to be able to use our electronic gadgets in a way that we still see the patient. Don't stick that laptop on the counter and turn your back on the patient. I personally leave my tablet in my office and chart between patients.
• Slow down. It is a rush to get through a bogged down schedule. But make sure no patient leaves with their questions unanswered. It always helps at the end of the visit to ask if patients have any more questions. It will save on phone calls down the road.
• Be careful of sales pitches. As a doctor in private practice, I have a long line of sales reps both online and in real life who have products they want me to buy. We should only incorporate those that provide services our patients really need or those that make our practice more efficient. Every company tells you if you buy their product and do a certain number of tests, you can earn this much money in a year. We are doctors. We don't order tests just to generate revenue. Remember your calling. Once you start looking at your patients to see how much you can earn off of them, you have lost your focus.
• Direct your patients to online resources. Your patients are going to consult Dr. Google, whether you want them to or not. There are all kinds of "health" information out here. Instead of discouraging our patients not to do this, we should give them credible sources. Ask them what they are reading online and what they fear. If we know the root causes of our patients' concerns, it is often easier to show them the real evidence.
• Remember the humanity of your patients. Patients are not their diseases. Patients come to us when they are feeling their worst and at their lowest. They may not be very nice to us. But we need to take the high road and remember their pain and suffering. Most of us were hazed as medical students and raked over the coals by some over-zealous attendings. We need to put the patient first. Of course, abuse from patients is a different story and none of us should be abused for doing our jobs.
• Be accessible. Some practices have complicated phone trees that make it difficult to speak to a live person. Some patients report that their doctors never respond to phone messages. If you really want to be patient-focused, the patient has to be able to reach you in a timely fashion. Consider evening or weekend hours, or secure email.
• Ask your patients what they want. We do periodic surveys of our own practice to identify what we are doing wrong and what we can be doing better. Patients can do it anonymously and we have been able to repair some inefficiencies in our practice flow by seeing it from our patents' point of view.
As medical care becomes more regulated and incorporated, patients are being lost in the shuffle. As doctors, most of us went into the profession because we want to help people and this is unacceptable. We need to take steps to make the healthcare system, as well as our own practices, patient-centric.