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Patient centered care – still a myth?

I am angry.  And disappointed. And embarrassed for the industry that I consider myself to be a part of.


My wife and I see different Internists in the same large, multi-specialty physician owned and managed group practice.  This is not a small operation, lacking in sophistication or scratching to get by.  I like my doctor.  My wife does not like hers.  I had an appointment scheduled, so she asked me to inform the practice of her desire to transfer to my doctor.

“Excellence, compassion and trust”, a declaration lifted from the practice website.  “a culture of caring, friendly and quality healthcare professionals”.  How many of our practices and institutions make similar pronouncements?

I learned quickly that the practice has a policy: patients cannot transfer from one doctor to another.  It was explained politely to me that this is a long-standing practice as a professional courtesy between physicians.  I explained that my wife did not trust her doctor (these are new relationships, by the way), that she wished to transfer to my doctor, but that she would leave the practice completely rather than continue with the physician she started with.  The administrator carrying the message continued to repeat the party line: policy is that patients do not change doctors.

I went further.  I like my doctor, but I will not use a practice that refuses to serve a reasonable request if the only reason for doing so is the feelings or pride of a doctor.  The administrator was very patient and polite (a demonstration of caring perhaps) but could only repeat that the request was denied because the doctors had agreed between them to honor the policy of “no transfers”.

Ok.  I can understand that practice partners should not “poach” patients from each other.  I can also understand that a popular physician’s patient load may be “full” and closed to new patients.  If my wife had a particularly complex medical condition which her doctor had deep competency in, but my doctor did not, then a transfer from a more capable practitioner to someone less skilled in the condition would be a sound reason to counsel against making a transfer.  Notice I said “counsel”.

None of these legitimate concerns were cited.  The DOCTORS said no to the patient.

“Excellence, compassion and trust”, “a culture of caring, friendly and quality healthcare professionals”.  This is a quality practice with an enviable reputation.  But I would challenge anyone to give them high marks for serving patients and their interests ahead of physician’s interests.  For physicians, the doctor/patient relationship is a professional one.  For the patient, this relationship is intensely personal.  Patients are more compliant with doctor’s orders, are less likely to sue for malpractice and enjoy a more positive frame of mind conducive to healing and best outcomes when they trust and have confidence in their doctors.  Sadly, this practice and, perhaps, most practices continue to serve the convenience and needs of doctors over those of patients.

This is a large market.  There are plenty of patients.  Losing two customers will not be noticed by anyone in the practice. We may be years or even decades away from patients acting in real volume as consumers in the health care marketplace.  Lack of meaningful, immediate consequences to volume and revenue should not prevent practices and physicians from demonstrating their care and concern for patients in policy and action.

Patient centered care is still subordinated to physician habits.  Actions speak louder than websites.

Is your practice paying attention to patients?  Engage BrightWork Advisory, LLC to put patients first.

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