Gregg Miller, MD
Front-line providers are crucial to the future success of our hospitals. No one knows better what our patients need and how to bring these solutions to life. We can’t hope to survive these tumultuous times without the engagement, leadership, and expertise of our clinicians.
Even before the pandemic, our healthcare system was changing at a frantic pace. Physicians and advanced providers are now practicing medicine in a space that’s fundamentally and forever changed. As leaders, how can we step up to help smooth their transition?
In this article, I share my predictions about the future direction of acute care medicine, plus practical steps health systems can take to prepare and empower our clinical teams.
Factors Affecting Practice
One of the most dramatic shifts to come out of the pandemic is the emergence of virtual care. Throughout the pandemic, hospital-based providers used telehealth to reduce unnecessary contact, reach high-risk patients at home, and free up inpatient capacity ahead of surges. Examples include hospital-at-home programs, which leverage virtual care and mobile teams to extend acute care into patients’ homes and other community settings.
Detaching care from a physical location like a hospital or medical office has the potential to improve access, decrease costs, and satisfy our communities. At the same time, it will fundamentally change the role of hospitals. Going forward, only the sickest patients will require dedicated face-to-face care in the hospital. While clinicians may see fewer patients at these “super-acute” facilities, they will need to dedicate considerable time, energy, and skill to clinical management.
Also, as care shifts beyond the hospital walls, acute care providers will be expected to provide greater continuity of care. The paradigm for an emergency physician will change from being the emergency department to emergency care, no matter where the patient is. This means being available not only for telehealth visits but also engaging patients via email and text messaging. While such accessible patient relationships have become the norm in primary care, they will be new to most acute care clinicians.
Challenges Ahead
What do these paradigm shifts mean for our valued clinicians, their well-being, and their job satisfaction? Beyond technical skills, providers need to perfect their “webside manner” to engage authentically with virtual patients. They also need tools to help them determine who can be safely managed via telehealth and who needs to be seen in person.
This new virtual care world could also exacerbate clinicians’ stress due to the unique demands of remote care. Providers need to learn how to treat patients remotely after years of education and training that focused on in-person care. This represents a completely different workflow and experience of being an acute care clinician that may be less satisfying.
How to Prepare
Given the intensifying pressures on clinicians, how can hospitals support their most valuable resource? Below I offer several recommendations about structural and cultural adaptations that have proven successful in hospitals nationwide, and how to engage clinicians in their design and implementation.
- Bolster your care teams by investing in hospital-based social workers, case managers, and care navigators. In addition to freeing up your clinicians, these professionals can boost hospital quality by improving lengths of stay and readmission rates. Patient navigation, both in-person and virtual, is proven to improve clinician satisfaction (and reduce hospital admissions) by ensuring that discharged patients receive needed support. This not only removes barriers to care; it also empowers patients to self-manage their health in a way that’s coordinated with their provider.
- Expand your hospital’s telehealth platforms and capabilities. Telehealth offers numerous benefits to patients and providers, and a well-chosen telehealth platform comes with provider training, analytics, and technical and implementation support. Such investments can pay a high ROI in physician satisfaction and loyalty, as they allow the provider to focus more on patient care. You’ll realize even more benefit when you involve physician leadership to support and champion implementation.
- Engage your front-line leadership as you adapt. Rapid systemic change often means opportunities to shine through leadership and innovation. Some professionals will also appreciate flexible scheduling and work-from-home arrangements. Leaders can accentuate the positive by engaging providers in change, providing protected time for innovation, and recognizing service excellence.
Focus on Opportunities
At Vituity, we’re committed to helping clinicians build long and fulfilling careers that endure through disruption and change. Our partnership model gives clinicians a voice in their practices and empowers them to lead change from the front lines. By treating physicians and advanced providers as our greatest innovation assets, we have improved job satisfaction and reduced burnout rates far below national benchmarks.
Healthcare has been through a challenging year that will continue to send shockwaves through our system for years to come. A critical part of our response is fostering clinician resilience and therefore the overall resilience of our health systems. By supporting and resourcing our providers, we are doing our best for our patients, hospitals, and communities.
Gregg Miller, MD, is chief medical officer at Vituity.
As a physician-owned partnership, Vituity’s 5,000 doctors and clinicians drive positive change in healthcare and deliver integrated acute care to nearly 8 million patients nationally. www.vituity.com