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The Times are Changing in …. 2015 and Beyond

[By Render S. Davis MHA CHE]

[By Dr. David Edward Marcinko MBA CMP™]

Medical practice today is vastly different from a generation ago, and physicians need new skills to be successful, and reduce liability risks while improving care delivery at lower costs.

In order to balance their obligations to both individual patients and to larger groups, physicians now must become more than competent clinicians.

Bedside Manner?

Traditionally, the physician was viewed as the “captain of the ship,” in charge of nearly all the medical decisions, but this changed with the dynamics of managed care and the health reform of the PP-ACA.

Today, the physician’s role may be more akin to the ship’s navigator, utilizing his or her clinical skills and knowledge of the health care environment to chart the patient’s course through a confusing morass of insurance requirements, care choices, and regulations to achieve the best attainable outcome.

Some of these new 2.0 “People” skills include:

1. Negotiation – working to optimize the patient’s access to appropriate services and facilities;
2. Being a team player – working in concert with other care givers, from generalist and specialist physicians, to nurses and therapists, to coordinate care delivery within a clinically appropriate and cost-effective framework;
3. Working within the limits of professional competence – avoiding the pitfalls of payer arrangements that may restrict access to specialty physicians and facilities, by clearly acknowledging when the symptoms or manifestations of a patient’s illness require this higher degree of service; then working on behalf of the patient to seek access to them;
4. Respecting different cultures and values – inherent in the support of the Principle of Autonomy is acceptance of values that may differ from one’s own. As the United States becomes a more culturally heterogeneous nation, health care providers are called upon to work within and respect the socio-cultural and/or spiritual framework of patients and their families;
5. Seeking clarity on what constitutes marginal care – within a system of finite resources, physicians will be called upon to carefully and openly communicate with patients regarding access to marginal and/or futile treatments. Addressing the many needs of patients and families at the end of life will be an increasingly important challenge in both communications and delivery of appropriate, yet compassionate care;
6. Supporting evidence-based practice – physicians should utilize outcomes data to reduce variation in treatments and achieve higher efficiencies and effectiveness of care delivery;
7. Fostering transparency and openness in communications – physicians should be willing and prepared to discuss all aspects of care and treatment, especially when disclosing problems or issues that may arise;
8. Exercising decision-making flexibility – treatment algorithms and clinical pathways are extremely useful tools when used within their scope, but physicians must follow the case managed patient closely and have the authority to adjust the plan if clinical circumstances warrant;
9. Fostering “patient and family centered care – whenever possible, medical treatments should be undertaken in a way that respects the patient’s values and preferences, and recognizes the important role to be played by family in supporting the patient’s care and well-being. For details on engaging families in this process, visit the website for the Institute for Family-Centered Care at www.familycenteredcare.org.;
10. Becoming skilled in the art of listening and interpreting — In her ground-breaking book, Narrative Ethics: Honoring the Stories of Illness, Rita Charon, MD Ph.D., a professor of Clinical Medicine at Columbia University’s College of Physicians and Surgeons, writes of the extraordinary value of utilizing the patient’s narrative, or personal story, in the care and treatment process. She notes that, “medicine practiced with narrative competence will more ably recognize patients and diseases, convey knowledge and regard, join humbly with colleagues, and accompany patients and their families through ordeals of illness.” In many ways, attention to narrative returns medicine full circle to the compassionate and caring foundations of the patient-physician relationship.

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[The Masks of Change]

Courtesy SplitShire

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Assessment

These represent only a handful of examples to illustrate the myriad of new skills that today’s savvy physicians must master in order to meet their timeless professional obligation of compassionate patient care; coupled with risk avoidance, assumption, transference and reduction mechanisms.

*NOTE: Health 2.0 is information exchange plus technology. It employs user-generated content, social networks and decision support tools to address the problems of inaccessible, fragmentary or unusable health care information. Healthcare 2.0 connects users to new kinds of information, fundamentally changing the consumer experience (e.g., buying insurance or deciding on/managing treatment), clinical decision-making (e.g., risk identification or use of best practices) and business processes (e.g., supply-chain management or business analytics.

About the Author

Render Davis was a Certified Healthcare Executive, now retired from Crawford Long Hospital at Emory University, in Atlanta, GA He served as Assistant Administrator for General Services, Policy Development, and Regulatory Affairs from 1977-95.  He is a founding board member of the Health Care Ethics Consortium of Georgia and served on the consortium’s Executive Committee, Advisory Board, Futility Task Force, Strategic Planning Committee, and chaired the Annual Conference Planning Committee, for many years.

MORE:

•  What Is Health 2.0?
• Insights on the Rise and Future of Participatory Health 2.0 for Physicians and Podiatrists*
• The 2.0 Healthcare Marketing Culture
• Faux Healthcare 2.0 Collaboration for Terminal Patients?

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

• PRACTICES: www.BusinessofMedicalPractice.com
• HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
• CLINICS: http://www.crcpress.com/product/isbn/9781439879900
• ADVISORS: www.CertifiedMedicalPlanner.org
• FINANCE: Financial Planning for Physicians and Advisors
• INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
• Dictionary of Health Economics and Finance
• Dictionary of Health Information Technology and Security
• Dictionary of Health Insurance and Managed Care

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Filed under: Ethics, Practice Management | Tagged: bedside manner, healthcare 2.0, Negotiation skills, Render Davis, Rita Charon MD | 1 Comment »