Tag Archives: ACO

Patient-Centered Communications – A Great Differentiation Strategy For Primary Care Physicians

More and more it seems that primary care physicians are becoming commoditized.   You know…where there is nothing to differentiate one group of physicians from another group of physicians down the street.

I really don’t understand why primary care physicians don’t make more of an effort to “stand out” from the competition in some meaningful way.   Being a former hospital marketer, I am even more surprised that hospitals systems, which now employ many primary care physicians, have been so slow to recognize the benefits of differentiating their physician partners from those across town.

That’s why I was surprised with a TV ad which I saw in my local San Jose market run by John Muir Medical Center in Walnut Creek California.   The ad is the first I have seen which uses their physicians’ patient communication skills to differentiate themselves from competitors.    Given that poor communication is the number one complaint most people have about their physician,  this is a great strategy.

In truth I can’t say that John Muir’s physicians are any better at communicating with patients than any other groups of physicians.  I would need to see evidence beyond that captured in patient satisfaction surveys.   You know…the same satisfaction survey everyone uses with the same wonderful results.   What I can say is that if in fact the ad is factually correct, John Muir is on to something.

With Patient Expectations Of Their Doctor’s Communication Skills Being So Low – It Easy For Physicians With Good Communication Skills To Stand Out

Poor communications is an issue for  my doctor and I.   I am reluctant however to change doctors because I doubt that other physicians are any better when it comes to patient communication.   But what if they were!

What if the physicians affiliated with a particular hospital system actually did communicate measurably better than their competitors?  With the advent of the Patient-Centered Medical Home, there’s lots of talk about primary care physicians becoming more patient-centered.    Why don’t hospital executives begin helping their physicians, both independent and employed, become more patient-centered in the way they communicate with patients through training programs?   After all patient-centered communication is the gold standard  for how provider should communicate with patients.  Even more interesting would be those same hospitals teaching patients how to effectively engage their physicians in discussing ways they can get more involved in their own care.

Just imaging patients walking out of your physicians’ offices amazed and delighted that their physician:

  • asked their opinion
  • invited their questions
  • was present in the moment and
  • actually listened to what the patient had to say.

Effective patient centered communication is one great way for primary care physicians and their hospitals partners can to avoid being commoditized and to stand out as market leaders.   Are you ready?

That’s my opinion, what’s yours?

Accountable Care and Effective Physician-Patient Communications – You Can’t Have One Without the Other

[tweetmeme source=”Healthmessaging” only_single=false]Accountable Care Organizations (ACOs) figure prominently in the new Patient Protection and Affordable Care Act.   The concept behind Accountable Care Organizations is that by tying both physician and hospital compensation to outcomes via a bundled fee (say for pneumonia), we can expect to see an improvement in quality and value.

In principal accountable care makes a lot of sense.   Practically speaking however, doctors and hospitals must address a huge challenge before they can expect benefit financially.

Before doctors can be held accountable for the care they deliver, they first must be held accountable for the quality of their communication with patients.

Take hospital re-admissions which are a big cost-driver today.   According to a recent study in the New England Journal of Medicine, 20% of all Medicare patients discharged from hospitals were readmitted within 30 days, and 34% percent within 90 days.

The Joint Commission and others believe rightly believe that inadequate communication between physicians, as well as between physicians and patients, is a major contributing factor.

Here’s an example.   In a small study of 47 patients surveyed at time of hospital discharge (Commercial and Medicare), 72.1% of patients were unable to list all their discharge medications.  86% were unable to describe the common side effect(s) of all their medications, and 58.1% did not know the diagnoses that put them in the hospital in the first place.  These trends are consistent with the findings from a number of similar studies, including studies of discharged ER patients.

Physician-patient communications shortcomings abound in the doctor’s office as well.    Approximately 20–50% of patients do not take medications as prescribed.  It’s not necessarily because patients are non-compliant.  Patients don’t take medications out of fear of drug interactions, perceived lack of effectiveness, adverse effects, misunderstanding regarding necessity, or concerns about costs.

Patients who report better general communication with their doctor, i.e.,  better instructions on how to take a medication, and who receive more medication information, are more likely to take medications as prescribed.

The success of new financing and delivery models like Accountable Care Organizations and Medical Homes depends heavily upon significant address the quality of the current state of physician-patient communications. I wonder when today’s physician and hospital leaders will get a clue.

Sources:

Makaryus, A., et al. Patients’ Understanding of Their Treatment Plans and Diagnosis at Discharge.  Mayo Clinic Preceedings, 2005.

Coleman, E., Rehospitalizations among Patients in the Medicare Fee-for-Service Program. New England Journal of Medicine. 2009.

Kripalani, S., et al. Deficits in Communication and Information Transfer Between Hospital-Based and Primary Care Physicians.  JAMA 2008.