Making Medicine A Team Sport

Americans only talk about the importance of teamwork. But most of the time, success is due to individual credit. Perhaps the most obvious example of this “MVP mindset” is healthcare.

A brilliant lone doctor fighting valiantly to save a patient’s life is the television-inspired image that most of us conjure up when we think of the medical profession. That archetypal hero was, in fact, the patient’s best hope in the last century, but times have changed.

No single doctor can effectively treat all of the 21st century patient’s problems. Healthcare leaders must debunk the myth that medicine is an individual sport.

team, team, team

this Series on Healthcare Leadership started by shining a spotlight on Importance of technology In moving medical care from temporary to permanent.Next was the need for a shift healthcare payment model From “pay for what you do” (do more, earn more) to a delivery system level where doctors are rewarded for preventing disease and achieving superior results. up to capitation.

In this final article in the series, we’ll discuss how healthcare leaders bring clinicians together to evolve medicine into a team sport. Doing so will help you achieve the measure of good leadership in the 21st century. This means superior quality, access to more care, and lower costs.at the same time.

As with any healthcare transformation, whether it’s adopting medical technology, driving payment reform, or building high-performing teams, leaders are thriving by using their brains, hearts, and spines differently. increase. You can think of it like this: Anatomy of Medical Leadership.

The first step is for leaders to detail the logical benefits of teamwork.

The Brain: Why Many Heads Are Better Than One

By the second half of the 20th century, the vast majority of patients suffered from acute and urgent problems such as pneumonia and perforated intestines. At that time, a single doctor could solve these problems by administering antibiotics or sealing the intestinal tract.

No single doctor today has the time or expertise to adequately prevent, monitor, manage and treat all patient issues. 4 in 10 Americans Have two or more chronic diseases.

Still, almost 50% of doctors remains in private practice, making it difficult to connect and coordinate with other physicians treating the same patients. The solution is for the leader to group the doctors into her one medical group or medical system.

The benefits of doing so are threefold:

1. 24/7 healthcare

Teams of doctors can provide care 24 hours a day, but independent doctors have no choice but to turn on automatic voice recording during off-hours and tell patients to go to the ER (usually during an appointment). even if it’s a problem you treat in the office). Day).

Imagine a group of 20 doctors. All promised her that every three weeks he would work one night or a weekend. Together, they can provide medical advice and treatment (virtual or in person) to all patients at any time.

This type of teamwork ensures quality 24/7 medical care at just one-tenth the cost of an emergency room. When Mid-Atlantic Permanente Medical Group provided this service, 70% of his patient problems were resolved in his one video visit.

2. Reduction in medical errors

A second benefit of teamwork is that doctors can share information through a common health record. This allows us to provide more consistent care so that no patient is overlooked.

according to The study of Johns HopkinsA team of clinicians who communicate regularly and effectively can reduce the incidence of medical errors, the third leading cause of death in the United States.

3. Giving Doctors More Time

In today’s healthcare system where doctors’ time is always in short supply, another advantage of working in a medical group or healthcare system is the ability to add professionals such as pharmacists, nurses, health educators and physical therapists to the team. It is possible.

These clinicians can adequately address many of the issues that bring patients to the doctor in the first place, such as the need for prescriptions, the need for disease education, and the need for treatment for musculoskeletal problems. increase.

We also encourage patients to better manage chronic conditions (diabetes, asthma, hypertension, obesity) and to assist individuals in making healthier lifestyle choices (cessation of smoking, healthy diet, consistent exercise). You will also have time to examine and follow up frequently. As a result, deaths from heart attacks, strokes and cancers have decreased.

Once the leader has detailed the benefits of the team, the next step is to connect with the compassionate side of the doctor.

Mind: Christie saved a life

When Kaiser Permanente first introduced electronic health records (EHRs) nearly 20 years ago, having comprehensive medical information available at every doctor’s visit improved service quality and avoided duplication of service. I knew I could. But office staff underestimated how effectively clinicians would use it to help improve people’s health.

There was one example that is still heartwarming through the efforts of Christie, a medical assistant who works in an ophthalmology clinic.

Medical assistants perform a variety of tasks, such as taking blood pressure, stockpiling labs, asking regular health questions, weighing individuals, and more. All of this information is incorporated into the medical record, allowing doctors to quickly check the patient’s health status.

Medical assistants do not prescribe drugs or perform invasive procedures, but they contribute to good care. Yet their efforts are often underestimated.

So one afternoon I was shocked to find Christie standing at the head of a conference room full of doctors and nurses. Everyone applauded when he tearfully received it.

For Christy, one morning a patient arrives for an appointment. After measuring the woman’s blood pressure and entering the information into her EHR, Christy realized that the patient had been delayed in getting mammograms.

It was clear that some doctors had already told their patients to call the radiology department and make an appointment. With permission from both the patient and the doctor, she made an appointment for a mammogram and accompanied the patient to the appointment at an adjacent building.

Most mammograms show no problem, but cancer was confirmed in this patient study. Surgery successfully cured a woman’s cancer early on, thanks to Christie, a result thanks to the latest technology and a dedicated team who felt empowered beyond her formal job description. It wouldn’t have been possible without the combination of her members.

Within our organization, this story has inspired hundreds of others to do more to save lives. , must also be maintained. You need a strong spine for that.

The Spine: Standing Strong in the Face of Uncertainty

2008 was a difficult year. The subprime mortgage collapse has sent banks and corporations into free fall. Companies laid off workers and cut health insurance.

As a result, the Kaiser Health Plan projected the loss of hundreds of thousands of members (patients) due to loss of coverage. This put serious pressure on the financial health of our medical group.The livelihoods of thousands of doctors, nurses and staff were at risk.

All eyes turned to leadership with concern. Everyone had relatives and friends who were laid off. Most corporate CEOs believed it would be wiser to lose a few sailors than to lose an entire crew.

We knew that the economic climate would eventually change and that we would all need to be on board to meet the future needs of millions of patients.

So instead of handing out pink slips, I told doctors and staff that I wouldn’t fire anyone. You will find ways to stagger and cut spending without negatively impacting care. We have asked some doctors, nurses and staff to work elsewhere or be flexible with their daily schedules. But I promised that no one would have to go home and tell their families that they were out of work.

This kind of commitment required a strong backbone in the face of enormous financial and reputational risks. But it was right. And two years later, membership skyrocketed again, so predictably, everyone needed them.

Ten years later, people still spoke of that day with great gratitude.

put the pieces together

By applying the latest technology, moving from fee-per-service to capitation, and investing in high-performing care teams, leaders can help organizations improve quality, improve access, and reduce costs. can be supported at the same time.

Success depends on your willingness and ability to use your brain, mind and spine differently than in the past.

So when should we start? As the sage and scholar Hillel said, “If not now, when?”