Physicians Incentivized for ‘Spending Time’ With Patients

CMS recently announced it will collaborate with private payers to reward primary-care practices for better engaging with patients and being more available to them. The statement comes on the heels of a University Chicago Medical School announcement that it is developing an institute devoted solely to teaching and researching patient relations skills. 

Both occurrences represent a larger trend: a growing acknowledgment among physicians, patients, educational institutions, and government programs that positive physician-patient relationships improve patient health.

“At the heart of medical care, at its very foundation, lays the relationship between the physician and patient,” University of Chicago President Robert Zimmer said during a press conference announcing the university’s new initiative.

This makes sense. The more comfortable a patient is with his physician, the more likely he is to follow up with him, open up about medical problems, and heed his advice.

Still, it’s difficult to acknowledge that a positive physician-patient relationship could potentially have as large an impact on a patient’s overall health as a procedure like an x-ray or a colonoscopy.

Perhaps that’s why, in the traditional fee-for-service reimbursement realm, no monetary value is placed on a physician’s patient relations skills. And, perhaps that’s why medical institutions have not spent as much time teaching students patient relations, as say, cancer screening.

So why is this increased value being placed on patient relations now? Most likely it’s due to the federal deficit, which is forcing officials to look for new ways to trim health costs without reducing quality of care. Improved patient relations may just be the easiest way to do that.

For instance, an extra five-minute conversation between doctor and patient does not cost anything more than the physician’s time - it requires no supplies, equipment, additional services. And yet, it can ensure that a patient better understands how and when to take his prescriptions, and therefore, it can help that patient avoid a more serious health problem down the road due to forgetting or ignoring his physician’s instructions.

“We know that when doctors have time to spend time with their patients and can better coordinate care with specialists, people are healthier and we have lower costs in the healthcare system,” CMS Administrator Donald Berwick said in a statement.

Participating providers in CMS’ Medicare pilot program, the Comprehensive Primary Care Initiative, will receive an extra $20 per month per patient for making themselves “more available” to patients.

A key facet of the program is rewarding physicians based on “engaging patients and caregivers.” Under the program, Medicare will also coordinate with commercial and state health insurance plans.

Physician-patient relations and communication skills “will be important for future career success,” Susan Baker, patient relations consultant and author, said via e-mail to Physicians Practice. And she noted, medical school is an “excellent time” for students to hone those skills.

In fact, the up-and-coming physicians at the University of Chicago’s new institute, the Bucksbaum Institute for Clinical Excellence, will be well prepared to participate in new initiatives, like the one just announced by CMS.

The institute will support physician-patient relations development by funding research into best practices to improve that relationship and by conducting patient-relations mentoring and teaching programs for students, among other initiatives.

Fittingly, the acknowledgment of the importance of a positive-physician patient relationship which lead to the formation of the institute came not from a physician, faculty member, or the university itself, but from a patient.

Carolyn Bucksbaum and her family decided to donate $42 million to the university after she was inspired by the positive relationship she had with her physician.

“Our doctor … showed us what good doctoring involved, and it was just as much about compassion and communication as his outstanding clinical competence," Bucksbaum said in a statement.