A recent article by Dr. Sandeep Jauhar intrigued us and challenged us. The author provokes a frank discussion of the real cost of doctors needing to work at increasingly frantic paces:
"There is no more wasteful entity in medicine than a rushed doctor."
In particular, the article pointed out that the mania for cutting payments to physicians actually does very little to address the real source of waste in the medical system: "Health care costs must be contained, but cutting payments to doctors is a self-defeating strategy. Policy makers need to focus on the drivers of waste." Spending that does not improve health outcomes -- waste -- accounts for $750 billion of the US healthcare costs. The author points to such sources of waste as unnecessary specialist consults, the costs of uncoordinated care, and primary doctors being left with confusion after a string of handoffs.
This perspective definitely resonates with us, especially since doctors are increasingly burnt out, expected to see double the patients in half the time, and still somehow have room in their heads and hearts for empathy. However, we would argue that the problem isn't simply calling in other doctors to help (as the author says at the end of the article), but the way in which they're called in.
So we propose that administrators and providers ask these questions as they bring in consults and specialists so that we can spend less on wasteful actions and more on providers' time with patients:
- Is the patient shuttled from provider to provider without any coordination?
- Does any provider own the care for the patient?
- Is the consult actually a conversation between providers, or is it more like a chain of handoffs?