What’s Wrong With This Picture?

There are a lot of problems in our healthcare system and many are not easily solved.  That is probably why this blog has been going daily for 16 years. When I read things I do it with a critical eye because many issues go unnoticed by others. Take for instance this article written by a Dr. Pelzman in MedPage Today.   Right off the bat there is lunacy that shouts out at me.  It is in the section Building the Patient-Centered Medical Home and the title is Right-Sizing the Medical Office – Good patient care means having enough people to answer their calls and greet them in the office. Think about this for a second.  The Patient-Centered Medical Home is such a made-up term and the whole discussion of the article is about having someone answer the phone?  I repeat, an article is being written because they can’t find someone to answer the phone.  

Now for some more fun.  By paragraph three he blurts out his Press Ganey scores and by paragraph four he talks about having “gone to our administrators and said look at this, is there something we can do about this, somehow the math of hiring more people to answer the phones just hasn’t worked out”.

Listen I am not trying to make fun of this doctor.  I don’t know him.  But I also didn’t write this.  He did and he put this out there.  Look at some of this stuff:

  • What business would put up with the fact that 30% of its customers are unable to reach them when they want to do business with them?
  • Despite years of complaints and multiple consultants telling us that we are woefully under-staffed with our telephone operators, the finance people have always said that according to the number of patients we see and the number of providers in practice, we should have plenty of people to answer the phones.
  • But the bottom line is that if we are going to innovate, improve, and reinvigorate the world of primary care, we’re going to need more support.
  • We going to need more space, more people to help manage population health, to address the specific needs of a group of patients who may be underserved, as well as the individual patient who is seeing us here today.
  • With all the bells and whistles of a fancy new electronic health record, and a system that gets our phone answered every time and increases the efficiency of our scheduling, we run the very real risk of only creating downstream work for people who are already overburdened by what they have to do today.
  • So no matter what, we need to turn things around, to do today’s work today, to find ways to overcome barriers instead of putting more of them up in front of our patients as we try to move them towards a better state of health.
  • If we can’t do this, if we can’t totally change the way we practice, the way we’ve built this clunky healthcare system into a monstrosity that just doesn’t work, then we’ve failed our patients, we’ve failed ourselves, and we’ve failed the future generation of healthcare providers who are coming up the line, hoping to be inspired to do what we do today.

Dr. Pelzman, the answers are there.  You wrote them but just can’t see them.  Let’s list them:

  • Press Ganey Scores
  • Going to our administrators
  • Ask the finance people
  • Fancy new electronic health record
  • Downstream work

Get rid of them!  Everything you “complain” about can be removed.  DPC has proven that.  Listen, not everyone is ready to leave the system.  I get that.  But if you think you can change the system from the inside then you are delusional.  The Press Ganey scores, the administrators, the finance people, the EHRs and the downstream work aren’t going anywhere.  In fact, they are getting worse.

Oh, and we always have a human answer the phone in DPC.  Every time.

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