Care quality, access and costs all have improved under a new approach to delivering care at the Scott and White health system in Texas, according to the chairman of the group’s board of directors, who spoke to physicians Friday at the 2014 AMA Annual Meeting.
Robert A. Probe, MD (pictured right), who heads the Scott and White Department of Orthopedic Surgery, explained how the group underwent a four-year transformation that allowed the group to dramatically decrease patient wait times, increase access to care and make strides in quality improvement.
“Most of our patients thought S&W stood for ‘sit and wait,’” Dr. Probe said, referring to one of the challenges under their previous care delivery environment.
“As an orthopedic surgeon, I was frustrated that I couldn’t see patients until their fractures were 90 percent healed because they couldn’t get in to see me for three weeks,” he said. “Now I can see every patient in a timely manner. If a patient makes an appointment that day, they can be seen that day.”
At the same time patients were able to see their physicians faster, a larger volume of patients also were being seen. According to Dr. Probe, Scott and White fielded about 1.4 million patients visits annually about a decade ago, compared to nearly twice that many last year.
How has the group achieved this kind of improvement? One reason is that the health system increased its total number of physicians, but Dr. Probe attributes the overall success to the fact that the group adopted a physician-led team-based model of care.
Under this model, Scott and White hired more advanced practice professionals, such as physician assistants and advance practice nurses, increasing physician efficiency as these health care professionals were able to practice to the height of their training and licensure.
Many of the time-consuming tasks that previously fell to physicians—such as in-depth patient education for chronic conditions—have been taken up by the physician assistants or advance practice nurses who report to them. Many of these professionals also have eagerly taken on a role in the group’s quality improvement efforts.
Dr. Probe said an important part of physicians’ responsibilities as leaders of these teams is education—both in helping patients understand how team-based care works and providing ongoing training for the other health care professionals on their team. Listening and responding to concerns also is important for cultivating the best environment for everyone.
The AMA is incorporating training for physician-led team-based care into innovative education models as part of its Accelerating Change in Medical Education initiative to better prepare future physicians for such responsibilities. A consortium of schools participating in the initiative are coming up with ways to give medical students early exposure to interprofessional education and working as physician leaders with other health professionals.
Meanwhile, through its Professional Satisfaction and Practice Sustainability initiative, the AMA is working to identify effective care delivery and payment models to improve the quality of patient care, reduce health care costs for the nation and increase professional satisfaction.
Physicians also can take advantage of educational webinars and practical guides from the AMA Innovators Committee to learn more about how to implement new care delivery and payment models into their own practices.
