MMA Viewpoint
Patient-Centered Care Improves Quality
Patient-centered care is one of the pathways to quality care. Most physicians agree with this concept, but we often have problems executing it.
Last year I started an advanced-access program and began to arrange same-day appointments for my patients. It required me to leave half my appointments unfilled at the beginning of the day and to no longer differentiate between the types of appointments I offer. Well-baby checks, complete physicals, athletic and employment physicals, and all other visits are each allotted the same amount of time. Sometimes I end up doing five complete physical exams in a morning. In the past, I would have done two. Although it has been difficult for the clinic staff to implement advanced access, I hear expressions of gratitude from patients who were able to see me the same day they called. This has been embarrassing because I was certain that I was seeing my patients in a timely manner before the change.
As we physicians work on improving quality, we need to consider our patients’ perspectives—as well as those of our care delivery teams—to make sure we’re meeting our patients’ needs. Too often, physicians don’t appreciate the complexity of their patients’ lives, how such things as transportation, child care, and the unpredictability of life may make it difficult for them to make and keep appointments. Providing patient-centered care means taking these things into account.
It also means taking into account the needs of groups as well as individuals. I recently represented the MMA at the Wisconsin Medical Society meeting. One of their resolutions stressed the importance of following the federal government’s mandate to provide care that is culturally and linguistically appropriate. I have visited practices around the state and seen how difficult it is to provide medical translation services. Some clinics are fortunate enough to be able to hire physicians and staff who are bilingual. But for clinics that serve patients who speak many different languages, the cost of translation services can be overwhelming, as the cost of translator services frequently exceeds payment for the entire office visit. The MMA is meeting with groups, including insurance companies, to address the need for payment for these services and find ways to provide better medical translators and thus improve care for our patients.
Another way to provide patient-centered care is to create opportunities for patients who have similar medical problems or diagnoses to come together as a group. Group meetings allow patients to learn from and be motivated by each other. At the hospital in Cloquet where I work, a group of people with diabetes are meeting with staff to discuss how we can best meet their needs.
Patient-centered care is patient-directed care, encouraging people to make decisions and take responsibility for their health. This requires physicians to advocate for patients and provide information and options rather than simply telling them what care they need.
As we learn to see the world through the eyes of our patients, it will become clear what steps we need to take to meet their needs. And we’ll find ourselves much farther down the path toward quality.