To create systems that support doctors and allow them to do the best possible job, healthcare leaders should keep three key principles in mind, according to a Health Affairs blog post.
Authors Jon Tilburt, M.D., of the Mayo Clinic and Susan Dorr Gold, M.D., director of the University of Michigan Medical School's Bioethics program, polled 62 primary care physicians and specialists from 10 focus groups. When they asked respondents what they needed from healthcare organizations to reduce waste, three major themes emerged:
- Point doctors in the right direction, but preserve autonomy: Meaningful waste reduction means finding a happy medium between full independence and micromanaging to the point that it restricts individualized care. That said, Gold and Tilburt write, an organization can give doctors their space and still encourage cost-conscious, patient centered behavior, such as reminding doctors about evidence-based options such as flu shots or cancer screenings.
- Foster meaningful communication and relationships: Physicians Gold and Tilburt spoke to describe the value--clinically and financially--of getting to know a patient. A physician who knows a patient's home life, of their history or lack thereof of sleep disturbance, is more likely to know whether that patient's headache calls for a MRI. Doctors who get to know their patients are less likely to order unnecessary tests or procedures, a major problem among physicians.
- Promote lower-tech care options: Although lower-tech options such as massage therapy, physical therapy and counseling have proven effective in treating various chronic conditions, higher reimbursement for higher-tech options means physicians may steer patients toward those options instead. Increasing access to lower-tech care (which is often cheaper and safer) could nudge doctors in this direction, Gold and Tilburt write.
These practices are better for business, as well, according to the post. "Signals from Washington and other payers indicate that fee-for-service payment methods will diminish, and with them the business case for 'more is better,'" the authors write. "Public and private payers are already experimenting extensively with shared savings, bundled payment, and value-based purchasing."
To learn more:
- here's the blog post