Why a “Common Ground Physician Message”? Through discussion of many of the known existing issues and anticipated challenges, our HCR taskforce members believe there is opportunity for growth and enhancement in patient care for the patients of Montgomery County. This is what the “Common Ground Physician Message” hopes to convey for the physicians of Montgomery County. Our message will begin to lay out a framework in which we offer options/choices for physicians to utilize to possibly enhance the care of their patients including serving the most vulnerable populations in our county.
What Are Our Core Beliefs?
To formulate our “Common Ground Physician Message”, we looked at the challenges listed above and asked the question: “As a physician community, what do we believe in?” Once answered, then we could discuss and decide the aspects of our health care system relevant to our beliefs in which we should take an active role in preserving. We decided this question was best answered using four complimentary categories:
1. PROMOTION OF PUBLIC HEALTH AND WELLNESS
· Actively support Public Health Dayton and Montgomery County programs such as “Get Up Montgomery County,” a community-wide healthy lifestyle initiative for children and families.
Advocate healthy choices with our patients, stressing to them that preventive health is their foundation of medical care.
· Recognize and impart the importance of patient accountability in their own health care decisions.
· Promote programs for “Chronic Disease” management
· Promote patient safety
2. IMPROVING APPROPRIATE ACCESS TO HEALTH CARE
· It is important for all physicians to share responsibility for care of all different spectrums of our society. Practical means to accomplish this include:
§ Expanding acceptance and participation in all types of insurance in our practice (i.e.: taking on a fair share of Medicaid and Medicare)
§ Volunteering in programs such as “Reach Out”
§ Specialists accepting consultations from FQHC’s and/or telephone/verbal consultations. MCMS will explore how our physicians can assist further in addressing the needs of patients who are underserved, to ensure issues such as professional liability are addressed.
· Accepting different types of medical practice models within our community that can increase access to care, such as the Patient Centered Medical Home Model, FQHC’s, and “Reach Out”, etc.
· Encouraging hospital systems to be more collaborative and synergistic in approaching the health care needs in our community.
· Importance of training future physicians in primary care fields of medicine. Ideas to foster this would include advocating for expansion of medical student scholarships and loan repayment for medical students going into primary care.
3. PERSERVING THE DOCTOR-PATIENT RELATIONSHIP
· Maintain focus on “Quality of Care” and strive to more clearly define exactly what that “quality” represents.
· Incorporate “Best Practice Guidelines” while maintaining our ability to treat our patients’ individual needs.
· Continue to be innovative in new diagnostic and treatment modalities.
· Study the impact of HIT on patient care and the doctor-patient relationship. Make sure that it ultimately improves quality of care and allows us to spend more time with our patients with less administrative burdens.
· Actively invest in our community through continued and open dialogue with our public leadership.
4. MEETING THE NEEDS OF OUR PHYSICIAN COMMUNITY
· ADOPTION OF ELECTRONIC HEALTH RECORDS:
A key piece of the new Health Care Reform Law is to convert physicians’ use of paper medical records/charts to “electronic” medical records. The hope is to enhance the ability of physicians to provide patients the best medical care with the use of this technology. Yet, there are many concerns with the conversion to HIT such as the cost of implementation and maintenance of these programs, patient privacy issues, and decreased access to care and/or productivity in medical practices during the implementation phase. It is important that these issues be addressed. It is equally important that physicians be “Good Stewards” of the potential this technology offers. We must ensure that the purposeful use of all recorded/transmitted patient data will be solely to provide the best medical care possible for that individual patient. It will be imperative that all channels that transmit data have the highest levels of privacy and security to protect our patients’ health information. Finally, it is of utmost importance that this advancement in technology shall not affect the “sacredness” of the doctor-patient relationship. It will be important to assist community physicians in adopting the necessary tools to thrive in the new electronic health care market (eg: registries, patient portals, e-prescribing, etc.). The Regional Extension Center offers some assistance but more needs to be done.
· INTEGRATION OF VARIOUS MEDICAL PRACTICE MODELS
The survival of the private practice of medicine in the midst of the new HCR law is critical. It will be necessary to remain open to different types of practice models as HCR evolves. Yet, it is our hope that the private practice model will not only survive but thrive. Physicians will have many different practice model options to choose from, including: the Patient Centered Medical Home model, Accountable Care Organizations (ACO’s), different forms of hospital employment, FQHC’S, etc.
Here perhaps is a key leadership opportunity for organized medicine to assist our physicians in better understanding the different models of practice available to them as HCR evolves. There needs to be a commitment to appropriately train community physicians in these new health care models. Whichever option is chosen, physicians need to be prepared to provide strong leadership roles to ensure that the models implemented are consistent with our core values.
· SCOPE OF PRACTICE ISSUES
Physicians acknowledge the importance of collaboration with other health care professions in providing patient care – accepting the need for complementary service providers in the spectrum of good patient care. We have a role to provide excellent training and ongoing support with adequate supervision. It is important to welcome the gifts and strengths of other health care providers yet it is important that we maintain our identity and profession as physicians.
· MAINTAINING OUR VALUES/MEANING IN MEDICINE
We must maintain our identity and our core values in the midst of this paradigm shift as that is what will guide our decisions through the changes inherent in Health Care Reform.
HOW DO WE CONVEY OUR MESSAGE AND TO WHOM?
Our HCR Taskforce discussed whether this message was valuable to share with the major stakeholders in health care. The taskforce was unanimous in agreement that certain aspects of the message are important to share with individual stakeholder groups which include physicians, hospital systems, patients, businesses, and legislative leaders.
We found it important to listen to our Montgomery County physicians’ concerns and questions in regard to the Common Ground Physician Message, and this was the purpose of our Town Hall membership meeting held on October 28th.
We also are planning on a joint letter with the Hospital Chiefs of Staff to be published in their respective hospital newsletters. And we hope to share our message at hospital staff meetings.
Perhaps the MCMS Board will consider working in collaboration with Public Health Dayton and Montgomery County to develop a Health Care forum to address specific public health issues. We encourage our physician leaders to continue to be available for talks to community groups and health care panels. We can develop appropriate messages to be shared through the editorial pages of our local newspaper.
The local Chambers of Commerce offer a platform for physicians to address concerns of health and wellness in the workplace. Also, we can discuss with them the importance of the different medical practice models and how these might benefit their business. We can highlight the economic impact of physician practices at multiple levels in the community: employment of health care and administrative workers, utilization of businesses such as accountants, retirement plan specialists, medical and office suppliers, etc.
Meeting with our legislative leaders is very important. It would be of most benefit to meet separately with the different levels of legislative leaders; local, state, and federal, to address various levels of issues and concerns. We hope to coordinate these meetings with our taskforce, interested physicians, and our representatives from OSMA and AMA.
In conclusion, it is the hope of our HCR Taskforce Committee that you will accept this Common Ground Physician Message to be beneficial to our community. Many of the ideas mentioned in the four categories of the “Common Ground Physician Message” are already taking place in physician practices throughout our community. In those situations this message serves to reinforce those ideas. However, many of the ideas such as implementation of EHR and involvement in new practice models are evolving as this article is written.
Throughout all this time of change and uncertainty one thing that remains true….our identity and core values as physicians and healers to provide excellent compassionate care for our patients will be our guide and lead us through the changes we will all face ahead.