3 truths about adapting to accountable care

Although not everyone in the healthcare community is on board with healthcare reform or accountable care models, there are certain principles that physicians practicing today will ultimately be forced to accept.

I had the opportunity to talk to two physicians who practice in my home state of Massachusetts about how they're adapting to the changes brought on by healthcare reform and other industry changes. While these doctors' organizations vary greatly in size and structure, they both recommend physician practices adopt the following mindset changes as they plan their strategic vision for the future.

1. Efficiency is essential

H. Eugene Lindsey, M.D., serves as president and CEO of Atrius Health/Harvard Vanguard, a nonprofit alliance of seven medical groups in Eastern and Central Massachusetts and Alain A. Chaoui, M.D., works as a solo physician at Family Medicine North in the Boston suburb of Peabody.

Both have prioritized efficiency as a key strategy for lowering practice costs and enhancing care.

"Even though the marketplace will not give us more in terms of dollars, we'll be able to do more for our patients with the dollars that we get if we become proficient in the use of these techniques of eliminating waste," said Lindsey (pictured right). As a result, the entire organization has adopted LEAN management techniques as a core competency across sites, he said.

Chaoui (pictured left), who practices with two nurse practitioners and a nurse care manager, attended a seminar in Washington, D.C., to learn the fundamentals of running a lean practice while reducing wait time and increasing patient satisfaction.

"Over the last few months I completely changed my office environment," he said. "Change is hard, but it's for the best interest of the patient and the physicians as well," he said, adding that physicians are often happier with their work lives once their workflow becomes more streamlined.

2. You are part of a team

Lindsey acknowledged that adapting to a team-based model of care hasn't been easy. "I've been practicing medicine for close to 40 years, where I only thought about my own ability to be self-reliant and conceptualized everything in terms of the way I wanted to do it," he said. "So the idea of working with someone else really requires a learning curve for me."

Key elements of that learning curve, particularly for older doctors, include learning to trust in the skills of one's colleagues, such as nurse practitioners, physician assistants and medical assistants, as well as understanding the changes to daily work flow, use of technology and interactions with patients, he said. "That really requires giving up some well-ingrained habits and acquiring new skills."

For example, since overhauling his practice, Chaoui now employs a nurse care manager to help meet patients' full spectrum of needs. And by embracing this team approach, Chaoui has been able to add health-maintenance services to every sick visit. By addressing other issues, such as missed mammograms or other tests, patients may have let slide during sick visits, patients have become more engaged in and satisfied in their care, he said.

3. Patient-centered care is not a fad

"The most important thing here is the old days and old ways of seeing patients are gone and the new ways are essentially about more effective, much more patient-centered care," Chaoui said.

Furthermore, Chaoui emphasized that this change in mindset needs to be embraced by all employees, physicians and leadership. "Everyone in the office understands that this is why we're here," he said. "This culture shift emphasizes that we now work for patients. We've always worked for the patient but remembering that really is the secret to succeeding in the future."

What truisms would you add to this list? - Deb (@PracticeMgt)

Suggested Articles

A former VA pathologist and a California neurosurgeon are both facing criminal charges in the deaths of patients.

Six technologies have had the most positive impact on the operation of physician practices.

To help eliminate the friction many patients face when trying to get their health records, startup Ciitizen launched a patient record scorecard .