Physicians can’t serve patients alone

Face it: Patients today are OK with not seeing a physician when it comes to their care. 

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In a recent study by PwC’s Health Research Institute (HRI), 75% of patients said they would be comfortable seeing a nurse practitioner or a physician assistant instead of a physician for certain services. Fifty percent said they would see a pharmacist.

Now this doesn’t mean that physicians aren’t valued or needed in the new healthcare consumer dynamic. And I know many of you don’t want to share your workload due to concerns about non-physician provider training (or lack thereof) and the fact that current fee-for-service reimbursement centers on you and your work, not those who complement your care.

But things are changing. 

For years, accountable care organizations (ACOs) and patient-centered medical homes have embraced team-based care, making primary care physicians the quarterback of a corps of providers focusing on the patient. And now with the approach of Medicare reimbursement reform focused more on value than volume, the trend is growing. And it’s what your patients want these days: someone to treat all their needs on their schedule.

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So it’s time to assemble your primary care “dream team.”

In its recent analysis of 1,500 U.S. physicians and 1,750 patients, HRI found that both consumers and clinicians are ready to embrace broader care teams to improve patient care. And since Medicare and private payers are basing more reimbursement on outcomes, the healthier your patients, the healthier your practice will be financially.

Next: To succeed, physicians can no longer go it alone

In fact, HRI found that a primary care dream team designed around the needs of complex chronic patients-whose improvement is crucial to providing quality care-could result in $1.2 million in savings for every 10,000 patients treated. Now you can tweak those numbers for your own practice to see that savings are possible.

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From discussions I’ve had with physicians, I know they do see value in adding new team members to their practices, but cost is often a concern. HRI found that while few practices today employ them, dieticians, mental health professionals, clinical educators and social workers were tops on the dream team wish list for primary care docs. (For more on integrating behavioral health into primary care, see our cover story on page 18).

Any primary care dream team should take into account patient preferences regarding who they are comfortable seeing and their complex health needs when drafting team members, HRI says.  So take a hard look at your patient panel and determine who would best aid you in caring for your patients.  Is it a dietician to help your patients with diabetes? Do you need a nurse practitioner to help with routine checks of elderly and/or frail patients? Would a mental health expert help you knock down barriers to better treatment compliance?

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Primary care is changing, driven by patient demand and reimbursement based on quality outcomes. To succeed, physicians can no longer go it alone.  By building a team of your choosing around you-either of employees or community partners - the end goal is still the same: better patient care. 

Keith L. Martin is editorial director of Medical Economics. Who would you add to your primary care dream team? Tell us at medec@ubm.com.