Making it Easier for Physicians to Provide Patient-Centered Care
Doctors and patients should partner with each other on the path to patient-centered care and improved physician satisfaction.
Dr. Bruce Hillman's editorial in the JACR, "It's About the Patient … Duh!" makes a strong case for moving from the traditional physician-centered health care delivery model, where doctors are the primary drivers of health care decisions, to patient-centered care, where patient needs and satisfaction greatly influences the health care experience. The idea is to make it easier for patients to get the care they need without encountering unnecessary hurdles, such as multiple trips to health care facilities or fights with insurance companies to get approval for necessary care. However, as much as physicians may agree with Dr. Hillman's proposal, they need help removing barriers that prevent them from making that transition.
To provide the best patient care, health care systems must make it easier for doctors to treat patients, for example; having adequate time to spend with patients during clinic visits and at the bedside; not having to spend two hours on EMR inputs for every hour spent with a patient; or scheduling a required test, medication, or procedure without automatic, non-value added, peer-to-peer consults for insurance approval.
Doctors also have to deal with "corporate medicine." As shown by the following illustration, the growth in health care administrators is exponentially greater than the corresponding growth in physicians. US health care spending rose 2300% from 1970 to 2009 which also tracks with the growth in administrators.
In fact, the administrative costs for US health care are two to three times those of other developed countries.
The Physicians Foundation 2016 Survey of America's Physicians found that 49% of physicians often or always experience problems of burnout; 80% of physicians are overextended or at capacity; and 48% plan to limit patient access by cutting down on hours, retiring, taking a non-clinician job or other action. Physicians spend 21% of their time on non-clinical paper work yet, 71% say that "patient relationships" are the most satisfying aspect of medical practice. One of the comments from the survey sums it up well:
"Medicine has been taken away from the doctors and patients. Doctors rank below hospital administrators and insurance companies in controlling the doctor-patient relationship today.
As patients, until recently, we didn't have much say in our own health care, and even less input into the health care system. However, as Dr. Hillman commented, patients are gaining power and leading a "political revolution." They are a disruptive force in health care. Now is the time for patients and doctors to join together and forge a new partnership of equals and take health care back from the administrators. If we don't do something, we will lose many of our doctors. That would be a true public health emergency.