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4 Resolutions for Physicians in 2016

   January 07, 2016

Based on a year's worth of interviewing and listening to physicians, healthcare executives, and patients, these are the top four things physician leaders should be thinking about—and doing—this year.

Instead of looking back at 2015 to analyze the good, the bad, and the ugly of healthcare, I'm taking a forward view and have put together a list of resolutions for physician leaders to consider making in the coming months.

They're based on a year's worth of interviewing physicians, healthcare executives, and patients for this column and for HealthLeaders magazine. I am not a physician, but I talk to a lot of them, and I listen really, really well.

1. Integrate mental health practitioners into primary care practices.
For decades, the mental health needs of patients have played second fiddle to other healthcare concerns. The Patient Protection and Affordable Care Act expanded mental and behavioral health coverage, but it is still not taken as seriously as it should be. Hospital EDs across the country are crowded with patients who are in crisis, and some hospitals are forming strategic alliances.

In New Jersey, five systems have formed the South Jersey Behavioral Health Innovation Collaborative to find a solution that suits patients, physicians, and hospitals.

But where do patients with mental health needs show up first? Their primary care physician's office is often a patient's first stop. In 2007, authors Patricia Robinson and Jeffrey Reiter estimated that 70% of patient visits to a PCP stemmed from a psychological issue. The Agency for Healthcare Research and Quality, which certifies patient-centered medical homes, recognized the mutual benefit of integrating mental health into PCP offices and now it is a PCMH requirement.

Including a mental health practitioner onsite, whether it is daily or a few times a week doesn't have to be disruptive. But, then, it depends on how you measure disruption in your office, which leads to the next resolution suggestion.

2. Aiming for value? Measure for performance and outcomes.
Physicians who are part of larger systems may be rolling their eyes (because they have metric overload) and that's fine. At least you're measuring! I talk to many organizations—large and small—who have big plans to improve patient experience, communication, physician leadership, etc., but don't have a plan to measure their improvement.

Scripps Health, the San Diego–based nonprofit health system, is taking value seriously, and while the large system has considerable resources, its management structure could be a blueprint for other, smaller organizations, too.

The management of Scripps' clinical service lines is done by two people, an administrator and a physician leader. It's an approach that engages all levels of staff and is reducing variations in physicians' offices, which, in turn, reduces wait times and improves patient satisfaction.

Jacqueline Fellows is a contributing writer at HealthLeaders Media.

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