Why do we not demand evidence when other experts, such as healthcare journalists, commercials, magazines, diet books and even Physician’s … report critical claims about medical therapies or public health? SMTE notes We have seen how the average Patient has become addicted to opinions, especially when it comes to health care and public policy. What if [DPC, Micro Clinic PCP Offices, Concierge, etc.] Physician’s married Evidence and Advocacy together? Let’s start with this question …
By Michael Tetreault, Editor-in-Chief
OCTOBER 2017 – The definition of Advocate according to Webster’s is: ‘one who pleads the cause of another; or, someone who fights for something or someone, especially someone who fights for the rights of others.’
ev·i·dence ˈevədəns/ noun: evidence
1. the available body of facts or information indicating whether a belief or proposition is true or valid.
How can merging [medical] Evidence and being an Advocate for your Patient be walked out today in your practice? What form of measurement can truly help you gauge your level of interaction and advocacy and use of evidence on behalf of a patient who needs your help?
Today we want to look at addressing these questions.
HEALTH DECISION SUPPORT TOOL – New Collaboration Between CMT & MPIRICA … Offers Over One Million Surgeon Quality Scores, An Industry First
Let’s look at your time.
Whether it is time spent with your Patient in the exam room, time spent on the phone, time spent researching and reading on behalf of that particular Patient’s illness or concerns, time is one way you can begin to measure your role as an advocate in their life.
Before we dive to deep, let’s circle the wagons around a primary problem. Lack of time spent with the Patient.
This past summer 2017, Concierge Medicine Today asked our Physician readers, How many questions do you ask your patients during their visit? BEFORE Concierge Medicine, How Many Questions Did You Have Time To Ask Patients?
The results are not necessarily surprising. They do put a lens in front of the problem though and help us see just where you may be able to help. The results found indicated
- Just over 60 percent of Physician’s said ‘Before Concierge Care, I Had Time to Ask Less Than 5 Questions per patient, per visit.’
- Slightly under 40 percent of Physician’s said ‘In Concierge Care, I Can Ask/Have Time to Ask Less Than 15+ Questions per patient, per visit.’
As we have now zeroed in on a common problem and a possible solution, in what ways can you advocate for your patients on a weekly, if not daily basis?
Increasingly, we are finding that as we interview and talk to Physician’s, both inside and outside of Concierge Medicine practices, inside hospitals, with surgeons, their medical teams and others, we are finding that time is a precious commodity.
Here are some helpful suggestions shown to us directly by our Physician readers in Concierge Medical Care over the past year.
This sounds really simple. It sounds like it shouldn’t be mentioned at all. But we all know that we all have days where this is forgotten and incredibly challenging. Even inside a Concierge Medicine practice.
Empathy is first aid for Patient’s. In difficult moments, heart breaking diagnosis and challenging Patient relationships, empathy can be the key to beginning a conversation that leads to health. When you empathize with someone, you see things you wouldn’t have seen. Their anger over the symptoms can turn into compassion.
Lack of empathy can infect any Physician-Patient relationship. And the quality of your care is only as good as the quality of the relationships you are forming with your Patient’s. Lack of understanding their busy lives or particular struggle with addiction or food or prescription compliance robs them of the peace they are seeking by having you as their Physician and yes, albeit, Life Coach in their life.
Third. Revise and analyze your referral network.
Who and where you refer your Patient to next is just as important as the next conversation you have with that same Patient. And, the outcomes and quality measurement of that decision nowadays is terrible. Just recently we learned that when some surgeons are provided with evidence supporting patient outcome data on a surgical implant and common device they use each day, they rarely read the evidence and other medical journal reports that support or do not support a particular device. They know they may have to bring the patient in for surgery in a couple of years for a second, third or even fourth time. We also learned they often opt to use a piece of equipment that yes, it will work just fine, but have they reviewed the evidence supporting that it is in fact, the best next step, implant or device? Will it have the best outcome(s) for the Patient years down the road? Or, is the decision to use a particular device often times gauged and determined by the relationship they have with the medical device sales rep?
We don’t know all the answers, nor claim that this happens all the time. However, if it is happening at a prominent hospital according to our sources, then it is likely that this is also happening elsewhere around our country as well.
OFFICIAL POSITION, STATEMENT: Use of Quality Scores for Hospitals and Surgeons based on Medical Performance and Evidence-Based Medical Outcomes.
Let’s dive a into revising and analyzing your referral network a bit more. Over the past year we’ve been asking Physician’s, When You refer A Patient For Surgery, How Do You Determine The Quality of That Facility or Surgeon?
The results were as follows:
- 29% said My Other Colleagues Told Me They Are Good;
- 8% said I’ve Met The Surgeon Only. First Impression Was Good;
- 21% said Other Patients Have Had Surgeries There;
- 7% said It is a local facility where most people go;
- 3% said I let a specialist make the appropriate referral. I do not know how they determine quality;
- 18% said My Patient(s) reported they had a good experience.
The data on readmissions and patient mortality inside a hospital require no subjective interpretation, the data on complications however, is not as clearly documented. This is due to recording complications that require individual judgment. Coders, healthcare professionals and their patients may differ in their interpretation of events. As a result, complications may be recorded differently across facilities (or even by different coders within the same facility). Furthermore, even if codings were consistent, the codes themselves do not always separate a mild complication (like a simple infection) from a serious one that requires greater medical attention (like sepsis).
A 2016 survey by CMT found that current surgeon referral methods lack any type of objective outcomes-based information. In fact, no respondents reported using actual data, with one-third replying that the primary way they choose a surgeon for their patients is based upon the opinion of a colleague who stated that the surgeon was good.
If you are new to the Subscription-based healthcare space and haven’t built up a trustworthy specialist and referral network, you can and should begin asking for the evidence and outcome data. Is here-say, a phone number and a smile from the colleague in the next medical office suite enough? Is that really the most appropriate way to ‘advocate’ for your patients? Relying on training, experience, referral networks, review articles, seminars, standards of practice is not enough. Physicians who merge their expertise with an analysis of the data found in clinical trials are in the best position to find the best therapy.Evidence is everything that is used to reveal and determine the truth. Medical evidence comprises medical knowledge, from clinical trials and published research, to reveal the truth about medical conditions and the safest and most effective treatments.
The Bottom Line
Direct Primary Care, Concierge Medicine and the like promises to design healthcare for specific needs, empowering patients through in-depth knowledge, and combing high-tech tools of today. This more extensive care for patients through memberships promises the best care and the most advanced tools of today.
Do you have any Patient Advocacy tips for other Physician’s? We’d love to hear your thoughts on this topic. Share your thoughts in the comment section below or on social media.