A recent NYTimes article described the efforts and effects of doctors involved in “patient centered”practices. While larger health reform is still an uncertainty, these doctors are already seeing benefits for both their patients and themselves.
What is “patient centered” care?
These doctors spend more than the usual 15 minutes, often 30-60 minutes per patient visit. They emphasize prevention and education, and can handle many medical issues without referral to specialists. Overall health improves and medical bills are reduced.
What are some examples?
- Dr. Jose Batlle, making a house call to a 93 year old patient, reduced her medications from 15 to 4, and gave her and her son his cell phone number. Since seeing Dr. Batlle, she has not had any ER visits or hospitalizations.
- Dr. Lili Sacks realized she lacked time for thorough exams, and that she was often forced to order tests and refer patients to specialists. She moved to a clinic that allowed for 30-60 minute appointments. Patients can now contact her directly by phone and email. She too has prevented a number of ER visits and hospitalizations.
How does this work?
- Doctors use technology to streamline processes and reduce administrative costs. They use online appointment scheduling and manage records electronically.
- Some offer ‘direct-practice’ services. A patient pays an annual fee at the clinic and takes out a higher deductible insurance plan, saving from 15 to 40% on their medical costs.
What are the benefits?
- The individual doctor is no longer compensated every time he/she sees a patient (the current insurance model). They can move beyond addressing immediate concern of the patient, beyond treating the symptom, get to the root of the medical problem and treat the whole patient.
- A study at Dartmouth Medical School shows that patients felt more informed in how to manage chronic conditions and felt they got the care they needed. They report they are less likely to have to wait for an appointment.
- The same study reports that doctors reduce their costs by using new technology and streamlining processes. They can see fewer patients without reducing their income.
What are the downsides?
- Electronic records can be breached and computer glitches can make records inaccessible.
- The nation may not be able to afford to have all of its primary care doctors reduce the number of patients they see. Medical school loans can be so high, doctors are sometimes drawn to a higher-paying specialty.
This article was helpful in presenting the pros and cons to this approach. I feel fortunate my elderly mother is already receiving this type of care from her primary care physician at her retirement community. She still seems amazed when the doctor will spend 30-60 minutes with her, and answer every one of her questions. It will be interesting to watch the big focus in Washington on health care reform. I’d love to see patient-centered care be more widespread.
(Source: http://www.nytimes.com/2009/06/07/health/07health.html?ref=policy
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Thanks for the useful info. It’s so interesting