How to Achieve Healthcare Transformation: the Patient-PCP Relationship

July 28, 2016

Quality how to achieve

How can you begin to realize healthcare transformation? Start with the most important relationship in healthcare.

Matching Patients and Physicians: Wants and Needs

Match.com is well-known for its algorithms that match potential romantic partners based on the relationship criteria that matter most. The site’s goal is successful long-term partnerships. In healthcare, the goal is better health in accordance with the triple aim of improved outcomes, lower costs, and improved population health. So what might CareMatch.com look like?

At its core, CareMatch.com would provide guided search with algorithms to match primary care physicians (PCPs) and patients based on criteria that doctors and patients deem important. According to recent Healthgrades surveys of 600 primary care physicians and 274 patients, those criteria are:

  • Convenience: This is the #1 consumer commodity. Availability is extremely important, including the ability to book visits online and regular night and weekend hours for urgent healthcare needs. Proximity also matters, so patients can seek care nearby. Telehealth is a differentiator, as it allows patients to seek care anywhere and at any time.
  • Approach to Decision-Making: Is a PCP paternalistic, patient-directed, or does he prefer some form of shared decision-making? Who does each party think should make the final decision? These are fundamental relationship questions. In a 2015 Healthgrades survey, 40% of PCPs indicated they would prefer to make the final decision about which treatments a patient should receive. None of them indicated they would want their patient to make the final decision. In contrast, 57% of patients prefer to make the final treatment decision.
  • Communication Style: Does a PCP come to quick decisions and give short explanations, or does she emphasize a more conversational style of communication? Will she ask more open-ended questions and listen without interrupting? Where does she stand on providing written materials and encouraging online education?
  • Care Philosophy: Core values matter to patients and parents. What is the PCP’s approach to vaccinations, breastfeeding, and circumcision? Is he passionate about physical activity and good nutrition? Does the PCP integrate complementary and alternative therapies?

These criteria illustrate why PCPs are an integral part of the healthcare transformation equation. Together, the doctor and patient must mesh well to create a platform for personal and population health.

This concept is critical because the PCP-patient relationship is built on trust. As Mark McClellan, MD, PhD,and Director of the Robert J. Margolis Center for Health Policy at Duke University, summarizes, “Consumers need to trust that they’re receiving good information that they can believe in before their behavior will change.”

Understanding Patient Churn

Annually, 20-35% of patients switch PCPs. Many physicians believe that this patient churn is due to outside influences like insurance coverage and network changes. But for patients, the desire to switch PCPs is also based on very personal preferences.

For example, patients recently shared their preferences on physician philosophies with Healthgrades. Fully 75% of them wanted a physician who listened without interrupting. Approximately 60% preferred a physician who encouraged online education and provided them with written materials. They also wanted a PCP who thought more broadly about treatments and wellness. An impressive 70% preferred a doctor who was open to integrating complementary and alternative medicine treatments. New parents indicated a preference for pediatricians who were flexible on the topic of circumcision but recommended breastfeeding longer. A striking 89% wanted a pediatrician who administered the HPV vaccination for girls.

Patients and parents are looking for validation, support, and ongoing quality of life in alignment with their values. But many physicians think differently about the above topics. Proactively promoting a good PCP-patient fit will reduce patient churn due to philosophical differences, while improving both patient satisfaction and clinical outcomes. Perhaps that’s why 100% of surveyed physicians indicated they were willing to publish their responses to the criteria above.

One hundred percent of physicians agree: Healthcare transformation depends upon PCP-patient compatibility.

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