Stop the Presses! Patient-Centered Care Lowers Costs

Jane Sarasohn-Kahn

First posted 7/20/11 on Health Populi

Patients who perceive their visit to the doctor was patient-centered, with more communication, receive fewer diagnostic tests and referrals, and yield lower expenses for diagnostic testing. A new study finds that patient-centered care leads to lower spending on health care over one year of care due to fewer specialty care referrals. A contributing factor to lower costs is increased patient participation during the visit, which reduces patients’ anxiety and perceived need for further investigations and referrals. In the milieu of more effective patient-physician communication, physician gets more knowledge about the patient. This brings greater trust between patient and doctor, as described in Patient-Centered Care is Associated with Decreased Health Care Utilization, published in the Journal of the American Board of Family Medicine published in July 2011, and penned by Dr. Klea Bertaks and Dr. Rahman Azari.

This is not a new concept: ten years ago, the IOM’s seminal report, Crossing the Quality Chasm: A New Health System for the 21st Century, called for “patient-centeredness.”

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Patients Are Losing Patience Over Time and Medical Bills

Jane Sarasohn-Kahn

First published 6/14/11 on Health Populi

When we use the phrase, “patient-physician communication,” we usually think about what goes on in the inner sanctum of the doctor’s office: in the exam room at the point-of-diagnosis, -care and -prescribing. There’s another form of communication that’s frustrating to both sides of the doctor-patient dialogue: phone calls. Patients are hanging up after long hold times, frustratingly waiting for important information about clinical care, insurance questions, and appointment schedule, according to a survey from Intuit.

“Patients are losing patience,” Intuit found. Earlier this year, Intuit learned a lot about what U.S. patients are looking for from their doctors: more self-service options, more online access, and more self-health care tools in patient portals. Furthermore, many patients would consider leaving their current physician’s practice if online options aren’t offered by their doctors, which I wrote about in Health Populi on March 9, 2011.

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Semper Paratus: Our Decisions About Emergency Care

Jessie Gruman

First published 4/20/11 on The Prepared Patient Forum 

Nora misjudged the height of the stair outside the restaurant, stepped down too hard, jammed her knee and tore her meniscus.  Not that we knew this at the time.  All we knew then was that she was howling from the pain.

There we were on a dark, empty, wet street in lower Manhattan, not a cab in sight, with a wailing, immobile woman.  What to do?  Call 911? Find a cab to take her home and contact her primary care doctor for advice?  Take her home, put ice on her knee, feed her Advil and call her doctor in the morning?

Sometimes it is clear that the only response to a health crisis is to call 911 and head for the emergency department (ED).  But in this case – and in so many others we encounter with our kids, our parents, our co-workers and on the street – the course of action is less obvious, while the demand for some action is urgent.

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Don Berwick on Patient Centered Health Care

Kenneth Lin

First published 2/14/11 on Common Sense Family Doctor

Brian’s Note: I saw this nice column by Dr. Lin and decided to post it as a complement to another effort that readers may be interested in. Over at Facebook is a page called 100,000 voices for Don Berwick. If you are moved to do so, please check it out and maybe post something on the wall there.

To me it is remarkable that Dr. Berwick, one of the nation’s true examples of servant leadership, has been politically excoriated. Meanwhile, we’ve heard virtually nothing from the leaders of the hospital world, who are, in my experience anyway, overwhelmingly Republicans and who have made the pilgrimages every year for many years to the Institute of Healthcare Improvement meetings, always with enthusiastic support for Dr. Berwick’s vision and activities. So much for conviction and expediency.

I stand with Dr. Lin and Dr. Steuerle below that we get the health care and the government we deserve.

100,000 Voices for Don BerwickI’m a big fan of Don Berwick, the current administrator of the Centers for Medicare and Medicaid Services who last week was on Capitol Hill being grilled by a congressional committee on his views. Although Dr. Berwick (a pediatrician by training) made his reputation in the area of improving patient safety and quality, his views on patient-centered care are what I admire most.

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Patient Centered Care and Health IT In A Nutshell

Kenneth Lin

First published 3/14/11 on Common Sense MD

Here is a brief excerpt from a narrative piece by internist Tasneem Bader-Omarali, MD in the February 25th issue of Medical Economics that encapsulates the limitless potential of integrating health information technology with patient-centered health care:

I was driving home after work one day when the answering service sent me a text. Mrs. Smith [a patient with chronic heart failure] was short of breath. I pulled over to the side of the road and, using my smartphone, logged on to my electronic health record. Mrs. Smith’s house was just a mile down the road at a nearby senior mobile home facility. On an impulse, I made a U-turn and drove to her house. Mrs. Smith opened the door and was taken aback. She invited me in.

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