Making primary care better for doctors currently in practice and attractive to medical students and residents is critical given the needs of our health care system. It also has been a major focus of the health care organization where I work. A few colleagues and I noticed that many primary care doctors still stayed later than others despite lowering patient panel responsibilities and the implementation of the nation’s most robust electronic medical record (EMR) where patient information is available and updated real-time 24/7.
Interestingly, this cohort was the same group that stayed later even when we used paper charts and had larger panel responsibilities. With patients expecting more in quality and service, the more we could support primary care doctors in specific tangible ways to make their work more personally and professionally satisfying, the better they could care for patients.
On my days off, I would observe my colleagues as they took care of patients and how they interacted with colleagues and staff. Based on these observations, I created this framework. This framework provides health care leaders specific areas of opportunity and focus to help support primary care doctors. The focus was on the individual doctor, the “team” at the office level, and the “team” outside the medical office.
The framework to make primary care better
- time management skills
- computer / technological / electronic medical record
- communication skills
- clinical skills
“Team” office level:
- support staff RN / MA
“Team” outside the primary care doctor office
We focused on EMR skills
Though an EMR has plenty of advantages, implementation and use of it in an efficient and thoughtful way was a challenge for many of our colleagues. Using primary care colleagues as “coaches,” offering suggestions, and being available to assist with a quick or complicated question resulted in colleagues saving 15 to 60 minutes per day. Many doctors were skeptical this approach would work. Yet by having a physician peer observe and mentor a doctor while she saw patients and managed her inbox, many problems and issues were identified that could be fixed quickly with some minor adjustments. This format allowed us to gain “quick wins,” momentum, and credibility. One doctor reported 2 weeks after his coaching session that he saved an hour per day.
The qualities of an exceptional physician “coach”
The physician “coach” was selected based on her ability to deliver great quality outcomes, provide excellent service to patients, colleagues, and staff, and who had very good bedside manner. In other words, she was the kind of doctor you would want for yourself, your family and friends. These doctors would need great empathy as they observed colleagues working in the office while also providing feedback real-time and coaching colleagues on tips that would make their work easier.
Colleagues have found this peer to peer coaching incredibly helpful is getting useful tips which are specific, personalized, and ideal for them. It has improved their effectiveness with the EMR and more importantly improved their relationships with patients. Less computer time and improvement in professional satisfaction. It is about building trusting relationships with patients. This is why we went into primary care.
We have moved on to providing colleagues time management skills as well as techniques on how to be better communicators. We have also started focusing on the “team” at the office level to ensure that our group of ten doctors per office worked seamlessly as a team of ten primary care doctors rather than simply ten solo practitioners located in one common office.
In the end after implementing this program and coaching over 200 primary care doctor colleagues we can say with much certainty our doctors are happier and feel supported in their work.
Doctors who are more professionally satisfied are more likely to provide exceptional care.
This framework provides health care leaders a way of addressing the issues facing primary care doctors in a tangible and impactful way through support of certain programs and the allocation of resources.
Davis Liu is a family physician and is the author of The Thrifty Patient – Vital Insider Tips for Saving Money and Staying Healthy and Stay Healthy, Live Longer, Spend Wisely. He can be reached at his self-titled site, Davis Liu, MD, and on Twitter @DavisLiuMD.