Why Doctors Working Less Means Healthcare Can Deliver More Part 2

In my previous blog, I described one perspective on how health care can do more with less…or more precisely, how inter-professional collaboration will improve access to family doctors, improve quality of care and create work places where many young doctors (and other clinicians) want to practice.

Dr. Kristy Williams is another BC-based family physician resident who sees a future in team-based care for a different reason:  she envisions new models that enable her to provide the kind of care that prevents people from having to visit their doctor in the first place!

Kristy realizes that there are limits to what a doctor can do – especially if we look at our health care system as means to balance both patient health and clinician self-care.  By working as part of a team with nurses, pharmacists and patient advocates, she feels well have a better system for everyone:  “We should be looking at models where patients feel better supported and have the tools to follow through on treatment plans. Research shows that up to 50% of patients dont fill their prescription.  Do we know why this is the case? We need get more patient involvement and feedback to help identify how care can be more appropriately delivered and I think that means breaking down the idea that working solo is best.  ”

Kristy feels that if we are able to do this, well be better able to assist patients to achieve health, and more importantly, to maintain health:  “If we address discrimination between types of clinicians with different training we will be able to focus on what we all bring to the care of the patient.  I’m personally inspired how we could mobilize upstream interventions, like using community gardens, art and social programs to prevent illness.”

Like many younger doctors, Kristy sees the fee for service payment model as a barrier to providing this kind of care: “Fee for service takes away from the focus on the patient, and its not sustainable because its not fulfilling for many physicians entering the profession.”  By encouraging limits like “1 problem per visit” it moves us away from providing truly comprehensive care and solutions that fit the life circumstances of people outside of the clinical setting.

From my conversation with Kristy and other younger doctors, we have an opportunity to shift our primary care system towards more and better care, with doctors working as part of a team and sharing responsibilities.  This reduces the burden of care solely on physicians…in other words enabling more to be done with less. In my next article, Ill be speaking with a young pharmacist who sees his future as part of a team with doctors and nurses.   I will also describe a new initiative that will develop models of care to increase physician and practice capacity by involving citizens in their design and operation. 

What do you think about a future where health care delivers more with less?