...Based on the characters created in my book, Heroes Need Not Apply, “How to build a Patient-Accountable Culture without putting more on your plate.” The book shows how focusing on what matters most to patients, having the right mind-set and a common direction can bring people together to ignite an entire organization.
My characters, CEO Jane Carolli and VPMA Dr. Jack Martin continue to craft a strategy to improve their culture by developing a cultural assessment tool to help drive change.
As they zero in on survey questions for the assessment tool, Jane found herself struggling with the issue of physician accessibility in light of a study she stumbled across.
As Jack came through the door of Jane’s office, she was so immersed in the data she found that she skipped the pleasantries, getting right to work…
“Jack, I’ve been wrestling with the validity of asking whether or not our physicians and staff are accessible to patients because I’m not sure if we can have much of an affect on the issue in general, regardless of the data we receive.”
“Well hello to you too Jane. What makes you think that?”
Jane looked up for the first time since Jack entered, “Sorry Jack, it’s just such a huge issue, it seems overwhelming. I’m reading about some finding from the Survey of American Physicians that says that 44 percent of physicians plan to reduce patient access to their services by any number of steps, such as reducing the number of patients they see, not accepting new patients, working part-time or moving to a non-clinical job. And, just 19 percent of physicians said they have time to see more patients. How are we going to have any affect on such a systemic problem?”
Jack thought for a few seconds before replying, “You know Jane, you’re right. If you look at it at such a macro level, it’s a huge undertaking. But when I think about accessibility to physicians by patients, I’m thinking about the micro level…”
“Meaning what exactly?” asked Jane.
“Meaning how patients see physician accessibility at the moment of care - at the bedside. Don’t you think we can influence that here at Angels of Seattle?”
Jane shook her head, “I guess there are two heads to the accessibility coin and I’ve only been looking at the macro side. I need to frame this issue from what accessibility really looks like from the patients’ point of view. This article stresses issues arising from the amount of time docs have for their patients, when I know from my rounding experience, that patients aren’t looking at the clock, they just want a more personal experience. Mostly, they just want to be heard.”
Jack knew better than to chime in when he saw Jane connecting the dots in real time. He waited patiently until she continued.
“You know Jack, when I was rounding yesterday, I asked patients about how much time they spent with their docs and how they felt about it, and none of them spoke in terms of quantity. They all said that it wasn’t about minutes spent, but how the minutes were spent. One woman shared that her physician never once looked her in the eye when they met, he never sat down, much less touched her. She said that she didn’t feel that she was treated as a human being.”
“It’s crazy Jane, here we are in the most human of businesses where we see people in their most vulnerable state, and we can’t even take a few seconds to show interest and actually connect with our patients? You know, earlier in my career I would often look down as I walked the halls so that nobody looked at me, because I was afraid they were going to engage me, and it seemed less threatening to keep them at arms length. I can’t believe that was even me when I think back on it.”
“Don’t be hard on yourself - you didn’t know any better at the time. So what can we do about it this problem in the here and now Jack?”
“Where do we always start Jane?”
Smiling, “With what matters most to patients of course. And we both know what they want. The interaction should have the full attention of the person you’re talking with… they want to be heard and treated like a person, not a patient.”
“Exactly Jane, we don’t have to tackle the big issue of physician time management, we just have to work with our staff to improve the quality of the interactions they’re already having — even if its only five minutes. By listening and learning from our patients, we’ll not only pick up the most accurate diagnosis, we’ll have the opportunity to raise patient experience metrics no matter how much time (or how little) we have.”
Jane beamed, “Like everything else we’ve been talking about, this is a cultural problem with a cultural solution. I had the incorrect assumption that accessibility was only about time. It’s not at all… at least from the patients’ point of view. Many of the great docs I know only have a few minutes for a patient visit and still manage to assure the patient by truly listening and build a trusting relationship.”
“Absolutely Jane. When we take the time to build a relationship up front, it not only dramatically improves the patient experience, it saves us time, expense and in some cases lives.”
“Yep,” said Jane. “Our docs that don’t take the time to give patients the human interactions that they need up front might think that they’re saving themselves time - but they’ll end up putting more time in anyway, when their patients come back in.”
“Pay me now or pay me later Jane… but you are going to pay me one way or the other.”
“And at Angels Jack, we have the ability to do something about this… and we will.”
Is your culture aligned to what matters most to patients?...