MGMA 2017: Want to remake healthcare? Start with the physician-patient relationship, says Fischer-Wright

Doctor with patient
The doctor-patient relationship is at the heart of medicine, says MGMA CEO Halee Fischer-Wright, M.D.

ANAHEIM, California—If timing is everything, Halee Fischer-Wright, M.D., couldn’t have picked a better time to come out with a book about the need to fix the country’s healthcare system.

“This is the preeminent issue of our time,” Fischer-Wright, president and CEO of the Medical Group Management Association (MGMA), said Tuesday during an interview with FierceHealthcare at the group’s annual conference in Anaheim, California.

Halee Fischer-Wright MGMA
Halee Fischer-Wright, M.D.

Given the debate in Washington over the future of healthcare reform, it’s an issue on the minds of many people. Fischer-Wright said she wrote the book, “Back to Balance: The Art, Science and Business of Medicine,” with three audiences in mind: fellow physicians, patients and practice executives.

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If the country is ready to remake the healthcare system, she says a good place to start is by focusing on its 17,000 physician practices, which are the foundation for the system. Her book starts with the premise that healthcare can be something better and the way to initiate change is by getting physicians engaged and empowered.

“Physicians are very disenchanted,” she acknowledged, and are also frustrated that no solutions have been offered for the problems that plague healthcare, from physician burnout to irritation with electronic health records.

Fischer-Wright says she is surprised by the positive reaction she's received for the book. “The number one comment is ‘you get me,’” she said, whether it’s from doctors or patients. 

“All of healthcare is looking for a way to enact change that is positive. One of my messages is that healthcare has to change from the ground up,” she said, since it all begins with what happens in a room between a physician and patient.

Physicians have control over their own practice

Fischer-Wright said she doesn’t have a prescription to fix healthcare and adds that looking up from ground level is overwhelming. “It’s like being 500 feet under the ocean,” she said. But she believes physicians can take steps in their own practices to begin to change healthcare delivery. While they can’t change the entire system, they do have the power to change their own practice. 

“It’s not the book sales that excite me. It’s starting a conversation to really bring about change. To get the outcomes we need get, we have to have a partnership between physicians and patients,” she said.

Healthcare is foremost on people’s minds, she said. About 70,000 people retire every week and are worried about their healthcare. Americans have watched the debate in the District of Columbia go on for months, as Republicans have tried and failed to repeal the Affordable Care Act, which would leave millions without health insurance.

She thinks medical practices can be successful from a business perspective and continue to do what they love to do. “I’m humbled my story has resonated with people. I hope it will catalyze change, which is the intent of the book,” she said.

Five shifts to fix healthcare

Fischer-Wright says five paradigm shifts must occur in medicine:

> Incentivize time, not money. Payers and lawmakers need to ask how to use time to encourage good outcomes, she said.

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> Simplify the complex medical system. Even the best-run medical practices need to hire 4.5 full-time people to support each physician in order to deal with the complexity of the healthcare system, she said.

> Lighten up on metrics so doctors can focus on relationships. It costs the country $8 billion each year for physicians to track and report on quality measures for regulators and insurers, she said. Healthcare should measure just the few appropriate factors and free physicians to build relationships that actually improve outcomes and costs.

> Move from process-driven to outcome-driven care. Start with the desired outcome, with a focus on the patient’s welfare and consideration of the art it takes to achieve the best results, she said.

> Shift from an "I win, you lose" attitude to a "we all win" attitude. “Healthcare has always been a nonzero practice,” she said.

Ultimately, Fischer-Wright says she thinks people will feel encouraged about the future after reading her book. “There’s hope. There’s a lot of promise, a lot of good in American healthcare,” she said.