For Top ACO or Team Care, Check Physician Egos at the Door
Obviously, there are no guarantees in the multidisciplinary approaches, and even the tiniest slips may occur, and could portend disaster. A few months ago, as I lay in bed waiting for an appendectomy, I saw a team of physicians approach patients to discuss what was anticipated during surgery. I could see and hear the team moving from one patient to another as they got closer to me.
Ah, I thought, multidisciplinary care at its best. The thought changed quickly. As the physicians reached the bed of a patient separated by a screen from mine, I heard the team of physicians explain what was expected, as they described the condition and details about the patient's condition and needs.
The only problem was they were talking about my condition, not the other patient's.
Oops, the physicians acknowledged: they realized they were speaking about my condition to the other patient. There were apologies all around.
The process is not without flaws, but as Thaler points out, the multidisciplinary approaches are the best way to improve patient care and minimize malfunctions. A physician trained in Austria, Thaler says he began embracing the multidisciplinary concept in the 1990s. A proper compensation plan to enhance the multidisciplinary work of physicians is essential, he says, and a physician's ego can be translated into something positive, delivering the "fortitude that makes it work"
Aside from the compensation, "it is most important to have a 'physician champion' who shares the vision and mission to do that," Thaler says. Such a leader is "an important factor to organize groups of physicians to develop their care plans, he says.
A physician champion is so important he or she should be specifically appointed within a hospital structure, according to Thaler. "If you don't have a clear appointment in such a position (that person) will most likely not be fully accepted," he says. The physician champion "should have the experience and knowledge and background that other physicians accept and look up to, and accept that person as an expert in the field," Thaler adds.
I thought of Thaler's comments about the need for proper protocols in establishing a physician team as I pondered the checklist phenomenon.
Perhaps the checklist idea should be expanded – something like a Physician Champion Checklist – to not only analyze clinical procedures, but to evaluate the attitudes of a physician team – so potential ego problems, for instance, can be checked at the door.
Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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