The conversation about accountability for care is well underway, and there is no turning back now. The road ahead for dedicated people in the clinic includes real uncertainty regarding how to deliver on this new promise of accountability from care coordination to capitated payments. But that road also represents the path of building the legacy of the clinic from the reputation in the community to the entity value if it were to change ownership.
It’s why being social as a clinic with a fully engaged staff is so important in the culture of care. Because the reputation does hinge on the physicians, but it is also influenced by everyone else on staff as well. For many in the clinic this idea of being social is just as much of a challenge between clinical and clerical staff as it is between those same people and patients. Too often the patient experience is defined by the need to fix a problem. So the interaction from scheduling the appointment to checking out following the examination is this routinized series of fragmented sound bite conversations.
The accountability for care does include being social and it must include a personalized dialogue between each patient and the clinic staff. It’s a big step from the “pay-for-the-transaction-to-address-my-latest-problem” experience that we’ve all become familiar with through generations of families. It is this unfortunate culture that has many in the clinic doing what a wise statistician once expressed to me as “checking your brain at the door.” What he meant was that too often people are so focused on the data that they fail to recognize the influence of human factors and individual differences of people.
Take the example of the receptionist who views each person as an appointment, insurance plan and a copayment. That information represents the data that she is too focused on as she overlooks the opportunity of the personal interaction with each patient. It can also carry through to the exam area where the physician views the patient in terms of the History of Present Illness (HPI) and one of a certain number of patients per hour in productivity. It’s important for everyone to reconcile the true expectations for the patient experience in the clinic in terms of appropriate interactions based upon knowledge, skills and training.
The reputation of the clinic has for so long been driven by the word of mouth reputation of patients. It still matters today even with our new levels of online or “virtual” interactions with social media. But being social is the foundation for any of these interactions, whether in-person or online. It matters because without the shared perspective of the importance of each interaction with every patient, it’s easy to fall into the trap of just issuing directives and broadcasting from your given role with that patient data in the clinic. So don’t check your brain at the door, bring it with you to all of those interactions because accountability for care is much more than just the patient’s data.