Viewpoint: Building patient-physician relationships more important than transactions

The U.S. healthcare system should "radically reorient" around relationships rather than viewing patient care as a series of individual encounters, three physicians said in an Oct. 4 Mayo Clinic Proceedings article. 

The article was co-written by Christine Sinsky, MD, vice president of professional satisfaction at the American Medical Association, Tait Shanafelt, MD, chief physician wellness officer at Palo Alto, Calif-based Stanford Medicine, and Alexandra Ristow, MD, lead primary care physician at Bala Cynwyd, Pa.-based Patina. 

Healthcare has become more transactional, with systems acting as if providers can seamlessly interchange patients, according to the article. This fragmentation of care disregards a patient's medical history, which inconveniences patients, creates more work and research for providers and can be hazardous to care outcomes, the physicians said. 

"It takes less time and fewer resources to evaluate a patient the physician knows well," the article said, noting that longitudinal relationships can decrease physician burnout. 

Further, receiving care from the same physician — especially in specialities that lend to longitudinal relationships such as neurology, oncology, psychiatry and primary care — has been associated with improved diagnostic accuracy, care coordination and patient satisfaction, fewer emergency room visits, hospital admissions and readmissions, lower costs and reduced mortality, the physicians wrote. 

The physicians proposed several strategies for health systems looking to refocus on relationships. 

Five of their suggestions: 

  • Maximize team stability by pairing the same nurse and medical assistant with the same physician each shift. 
  • Give the care team more control over scheduling, including start/stop times and visit durations. 
  • Design more "human" EHRs: For example, replace chemical names of medications and other "clutter" with patients' photographs. 
  • Support team communication through short "huddles" and "check-ins." 
  • Remove the "sludge" of unnecessary documentation and signatures to give physicians more time for visits. 

Read the full article here

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