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For the medical home to be successful, listen to the patients

Fred N. Pelzman, MD
Physician
January 12, 2014
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Standing in the middle of a massive hotel convention center hallway with thousands of people wearing name tags.

Not where I usually spend my days.

I have been asked to join senior management at a national client conference for the company that is providing patient survey data to our institution, those surveys patients get in the mail asking about their “experience” during their visit to our practice.

Everybody here wants the same thing, everybody here wants to make things better. Everyone has a different agenda, and everyone has a different idea how to get things done.

Massive, earth-changing ideas focused around transformational care, thought leaders from the world of health care challenging us with ideas on how to remake the system locally, nationally, globally.

Individuals from small practice administrators to front-line workers, sent to bring a little bit of change back to their home, a small idea hoping to improve the lives of their patients, their staff, their clinicians, and hopefully alleviate some of the suffering created by our system along the way.

A new way to collect patient data, a new way to present patient data, a new way to report, the next big thing. This is going be the thing, it’s going to get us where we want to go, this is the system of information management that will give us what we all really need. Is this, could this be, the wave of the future?

When the national leaders speak, we all listen, at rapt attention. When the rock stars of the health care industry and political superstars and reality television stars talk, we stand and cheer. When the presenters at the smaller booths talk we listen, trying to figure out how this fits into our lives, trying to figure out if this is that one thing that’s going to be the game changer.

Handouts, PowePoint presentations, glossy magazines, kiosks, slick presentations by well-trained presenters, salesmen masquerading as members of our team.

I know we all need this, we need good hard data to lead to change, I know this is trying to do some good. We recognize that it is hard doing our job, and none of us is intentionally ignoring our patients and their needs, leaving unfulfilled their desires for achieving perfect health.

And when we get those “report cards” showing our low numbers, we all think, this is somehow a reflection on me, it’s personal, there must be something wrong with the data, this can’t be what my practice is really like, this cannot be what I am like as a provider.

For our patient-centered medical home to truly be patient centered, we need to hear the voices of our patients, to listen and learn from their experiences moving through our practice. Any change needs data to help us evaluate that change. Did we really make things better? Did we accomplish what we set out to do? We can think that any change is a good change, but hopefully we have learned that this is not always true. And just getting more data is not the answer either.

By engaging the entire patient-centered medical home team with the process, and getting the data right, and helping those collecting the data know what we need, we can hopefully hear the needs of our patients, and this process can really help us fill those needs.

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Fred N. Pelzman is an associate professor of medicine, New York Presbyterian Hospital and associate director, Weill Cornell Internal Medicine Associates, New York City, NY. He blogs at Building the Patient-Centered Medical Home. 

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