Physician Practice Consolidation, Patients, and Process

Healthcare systems appear to be on a late night binge lately, gobbling up Physician practices as fast as they can.  It all seems to be part of their “Physician Growth Strategy” – otherwise known as “rather than entice physicians to practice at my system by providing exceptional service and patient care, I’ll just buy them out, make them employees, and structure their contracts so it is to their benefit to send the patients to me.”  Well, whatever the reason it’s happening a lot.

Mark Carter recently wrote about his experience with his newly acquired physician on his Healthcare Strategy blog.  His physician stated the usual reasons for being bought out – increased back office efficiency, electronic medical records, help with contracting, etc.  Not mentioned, but probably a major driving factor was income stability – a salary not dependent upon patient mix (that was now the Healthcare Systems problem).  [Click here for the entire article]

While this was all good for the physician, what about for the patient?

As Mark indicates, his experience demonstrated none of the benefits the physician entered into the arrangement to begin with; in fact, it was quite the opposite.  There was no electronic record, scheduling was a hassle, and customer service? What customer service?  If not for a 20+ year relationship between Mark and his doctor, he’d likely take his business elsewhere.  His physician probably has no idea his patients are being treated this way, or writes it off to one of the sacrifices of “being part of a big system.”

None of this has to do with the actual care received from a clinical perspective, but it does show a major problem with the care received from a personal perspective.  The staff in the office is probably trying to do a good job, after all, most people don’t go to work wanting to do a bad job; but the system is keeping them from doing so.  Unfortunately, their frustration with the system is impacting their relationship with the patient – the customer, in a very negative way.  I’m sure they would love to be able to schedule 12 months out, or have the patient come in early (if they wanted) to get their labs done.  But since the system doesn’t allow this, frustration sets in.  Mark may have been the 10th patient that day to say something about the inability to advance schedule.  It may have been the 1000th time the scheduler had to deal with a frustrated patient.  I’m not saying the reaction was acceptable, but when looking at the big picture, it is not unexpected.

Clearly this practice could use several process improvement techniques to improve flow, enhance communication, and improve patient satisfaction.  Although the technology issues can’t totally be resolved, dealing with them could be improved until the promised new technology arrives.

But what is also needed is an understanding by Healthcare System that simply buying out Physician practices to pad the numbers does nothing for patient / customer satisfaction.  Many parts of healthcare are becoming commoditized, and the traditionally strong patient / physician relationship is weakening as physicians become less engaged in the total patient experience (not the clinical care), and as patients become more aware of their choices as consumers.

Healthcare Systems can address this by improving their process, with the people that perform it each day, and implementing technology that allows for a seamless patient / customer experience.  Those that do will have a strong competitive advantage.

Let me know your thoughts!

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