Several years ago, when my kids were young, I remember consulting with another doctor at my son's Little League practice. We were both a few minutes early to pick the kids up and as we watched them chase grounders, we talked easily about Mrs. Schmidt's next surgery and whether Mr. Falen's family had visited.
There was a point, in fact, in my career, when all medical collaboration happened in this informal way. Nurse, doctor, aide, specialist, and generalist saw each other in hallway and lounge. We chatted between things, in elevators, over danishes in the cafeteria, and by phone. We crossed paths frequently enough that the collaboration came with little effort.
Things gradually shifted, though, for better and worse. Now we have hospitalists, urgent care in stores, and critical care in teaching centers. We have an alphabet soup of acronyms -- HIPAA and EMR the least of them -- that you could drown in. We also have breathtaking advances in care and medicine and surgery. And we have smartphones.
So when people ask me why medical providers aren't collaborating, I hesitate. I know that collaboration and telemedicine can be rewarding and transformative but I also know all the barriers to collaboration that have built up around all of us. I know that my colleagues -- whether an aide or a specialist -- value care coordination, patient-centered care, and working together to find the right answers. And I know that this coordination gets harder every day.
It comes down to something officially called "workflow" and unofficially called "how we move through our days." The old workflow, in which our collaboration and coordination happened organically, is no longer possible. And the current workflow, in which distraction and isolation reign, isn't sustainable or acceptable.
So I'm starting to believe that the answer is to intentionally start to create a new workflow that embraces the current reality and context in which we work -- but reintegrates the way we used to relate to each other as providers. Care coordination and collaboration tools, like iClickCare, get us part of the way. But it's up to each of us to start reimagining our workflow to include those conversations and collaborations we used to have, but incorporating our new reality, our new tools, and our new schedule. Little League may not be a part of our collaboration workflow anymore. But the easy, informal, rewarding conversation about a patient? That can be.