January 13, 2013

A better way for medical care


The price is that some medical practitioners view themselves more as independent contractors than as medical team members. Their team is like the Yankees — a group of extraordinary athletes who work as a team only because it is sometimes in their shared interest.

Of course, the Yankees win more than their share of World Series. A huge payroll can buy enough talent to succeed.

There is another way. It emphasizes the team over the individual. A medical group in Alaska that primarily serves a Native Alaskan population developed an approach in which a team leader guides a series of nurses and nurse practitioners, general practitioners and specialists, therapists and administrators, all of whom focus on the needs of the patient. The entire team meets to discuss the progress of their patients, and information is fluidly shared among them.

This team approach has reduced costs significantly. Repetitive tests are avoided, better communications ensure more consistent progress, and therapies work synergistically rather than at cross-purposes. Costs are reduced while quality is enhanced, simply by shifting the focus to the patient and the team rather than a collection of individuals loosely assembled around the patient’s disease.

Doctors and nurses at CVPH, health-care providers in Clinton County and the commissioner of health in New York State, Dr. Nirav R. Shah, appreciate this more holistic approach. Our local hospital has been collaborating in teams at CVPH and with primary-care physicians in the North Country to provide the most effective patient-practitioner partnerships for each disorder, with the patient as part of the team rather than a vessel of the disease. Hospital nurses and primary-care physicians assume the significant role of coordinating care among various providers. Information is shared electronically among team members, and the most efficient procedure provider is rewarded accordingly.

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