A Physician Centered Medical Journey

Andrew Slotnick

Nearly all of my professional life has been spent navigating the often blurry line of where the business of Healthcare meets the practice of Healthcare. Gaining competitive advantage in this area does not depend on recognizing key trends industry trends; it depends on recognizing how those trends affect customers. Although I am slightly removed from those blurry trenches today, staying in touch means keeping my edge.

I met my cousin last week for lunch so that she could tell me a little bit about Patient Centered Medical Home (PCMH), that I keep hearing about to, you know, stay sharp. Meg is the project manager for a large outpatient, multi-specialty, multi-provider clinic at a nearby teaching hospital and she is currently navigating her clinic towards PCMH certification. Unlike Ammonoosuc Community Health Services, a fully functioning PCMH that was highlighted by my colleague Sue Feury in a post earlier this year, Meg’s clinic has not yet achieved PCMH certification.

As she walked me through some of the nuances of her PCMH journey, my line of questioning narrowed. I wanted to better understand the PCMH users are and how are they being affected by this new method for delivering care?

Meg explained that Monday through Friday five different specialties roll though her clinic and that Monday through Friday five different processes, procedures and personalities define the type of care delivered by her clinic. The hospital that Meg works for has subsequently recognized that her clinic needed to be run more efficiently. Becoming PCHM certified is her first response to that need.

I began to share some thoughts with her about EMR technologies that I thought could help, but very quickly could tell by the look on her face that I was missing the mark. So to cover for my clear misunderstanding I asked another question.

“When will you finally become a PCMH?” She said that she didn’t really know if her clinic would ever become PCMH certified, but that that was completely ok. For Meg and her group, the pressure to establish a more efficient clinic made PCMH certification a good choice. But for Meg, efficacy wasn’t the problem. For Meg the five different specialties, all practicing in individual own silos, that were stretching the resources of her clinic was the problem.

So why was it ok that she did not know if her clinic would ever get the certification? The expression on Meg’s face then changed, like she was about to tell me a secret. She explained that every week for 60minutes, she was given the authority to sit members of all of her specialties down, in the same room, to discuss PCHM. The resulting conversation had little to do with PCMH though she explained, but that most of the time was spent discussing best practices and sharing experiences within the clinic.

PCMH may be the answer to the clinics problems she said, but better communication she glowed, was the solution for her clinic’s success.


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