The key to a thriving practice

Excerpted from “Majority of ETSU’s Quillen graduates heading into primary care,” Johnson City Press. April 25, 2015 — As the world of health care dramatically changes around East Tennessee State University’s Quillen College of Medicine, Dr. Kenneth Olive, a professor and associate dean for academic and faculty affairs, is still seeing medical students follow specialties about which they’re most passionate. The majority of the time, ETSU’s statistics show that this passion is involved with primary care, which includes family medicine, internal medicine, pediatrics and general obstetrics and gynecology. For the May 8 graduating class, 52 percent of the students are going into the primary care field.

Olive meets with each and every one of the 59 graduates, getting a sense of their time at the Quillen College of Medicine and what path they’re currently on. They discuss job options and how to be competitive as well, citing the changes in health care. Changing reimbursement models, electronic health records, the effects of the Affordable Care Act and the use of team collaboration among health care professionals are some of the topic issues in the field.

Dr. Brian Cross, an associate professor and vice-chair of the Department of Pharmacy at ETSU’s Bill Gatton College of Pharmacy, and Dr. Reid Blackwelder, a medical professor in the Quillen College of Medicine, recently delivered the keynote address at the American Pharmacists Association annual conference in San Diego in late March, centering their talk on the ongoing transformation of the health care system and the need for collaboration to meet the needs of a community and the outcomes a patient meets.

Citing egos and the established hierarchy among health care providers, the pair have made it their mission to start a collaborative mentality early on in a student’s education. “That’s something that we’ve been doing at ETSU,” Blackwelder said. “There’s no question that this is a very powerful and readily available way to improve outcomes.”

Through team collaboration, ETSU’s involvement is leading the charge in the way a patient receives health care in this area, which is getting noticed across the country. In his opinion, the use of team collaboration is huge for community-based medical schools and health care systems.

Commentary

Family Practice Physician Peter Anderson, MD: “As a family physician of 30 years, I was negatively impacted by the changes that came from an aging population, health information technology and declining reimbursement. But teamwork became my practice’s salvation. As much as ‘collaboration’ is needed between the larger entities of healthcare like pharmacy, nursing, behavioral medicine and community resources, it would not have fixed the difficulties I faced daily in the exam room.

“Two main responsibilities are associated with the primary care exam room. The first is the compilation of a complete medical picture and decisions for the patient’s care. The second is the documentation of data and explanation of decisions to the patient with the necessary education and implementation of actionable steps. The first part is physician work; the second is non-physician work. The first part is effective today because it evolved as medicine advanced. The second is broken and archaic because the process has not changed for the last century.

“We have accepted the notion that only the physician belongs in the primary care exam room. This belief has led to a delivery process that absolutely fails to make primary care physicians accessible. And this failure of the delivery process is the only reason primary care practices are not thriving.

“The problem is the delivery process, not primary care itself. Primary care is incredibly valuable and desperately needed. But the lack of teamwork in the exam room has kept our product from our culture.

“Build a team inside your exam room and your practice will thrive.”

Resources

June 2015 Christian Doctor's Digest Interview with Peter Anderson, MD - Joyful and Efficient Patient Care (CMDA member only content)

The summer edition of Today’s Christian Doctor includes an article by Dr. Anderson with more information about team care medicine. Visit www.cmda.org/tcd for more information when this article becomes available.