Care Redesign
Clip
When Patients Want the Doctor, Not the Team (01:48)

Sometimes, patients just want to see the doctor — not a care team. “How do you navigate the way we get work done with the way patients perceive they want care?” Care Redesign Lead Advisor Amy Compton-Phillips asks Bastiaan Bloem, Founder of ParkinsonNet, and Sara Singer, Harvard expert on health care policy and management.

“Can I frankly disagree?” asks Bloem. “I think this old-fashioned idea that patients are stuck or married with their physician is an old idea. A unique role, but not the only role on the team.” Bloem describes ParkinsonNet’s voice of the customer program, during which patients said they would rather see the nurse for certain problems. “Most of our patients, when you let them speak freely with this new approach, told us they rarely need the physician,” he says.

“I do see both of those kinds of patients,” notes Singer. The difference, she says, lies with the physician and other providers having a strong relationship and shared knowledge about the patient. “Sometimes, if a physician can introduce the other provider to the patient, to give them the confidence that they are in fact collaborating, know each other, share the same information, it gives so much more confidence in the relationship that the other provider can have with the patient,” says Singer. “People call them warm handoffs, but it makes an enormous difference.”

From the NEJM Catalyst event Care Redesign: Creating the Future of Care Delivery at Kaiser Permanente Center for Total Health, September 30, 2015.

More From Care Redesign

Measuring Performance of OpenNotes Initiatives to Target Improvement Efforts

How a New York safety-net health system used data science to identify obstacles to OpenNotes use, address technical barriers, and develop strategies for improving clinical note sharing by providers and viewing by patients.

Mapping a Technology Strategy for Bundled Payment Care Using a Value-Driven Framework

Harnessing Emerging Information Technology for Bundled Payment Care Using a Value-Driven Framework

A four-part framework developed by physicians at Partners HealthCare provides a stepwise process for assessing and integrating technologies to effectively use data through a continuous patient experience.

UCLA Health CKD Risk Stratification and Management

Proactively Catching the Declining Patient

A coordinated effort by UCLA leaders to identify a high-cost population with chronic kidney disease and to modify care processes and personnel has led to improved health and reduced utilization.

Telehealth and remote monitoring are little used and ineffective for chronic disease care

Survey Snapshot: Treating Chronic Disease Proactively

Though survey respondents don’t indicate strong use of telehealth and remote monitoring, NEJM Catalyst Insights Council members discuss the ways they’re using these tools to monitor chronic disease, with good results.

Platforming Health Care Operations - Consumer-Driven Health Care - Business-Minded Optimizations

Platforming Health Care to Transform Care Delivery

Health care leaders need to focus less on ownership and control of the delivery process, and more on outcomes, cost efficiency, and customer experience.

Shah05_ integrated systems innovation pullquote

Build vs. Buy: What Should Health Systems Do?

The consolidation craze continues, but vertical integration has yet to demonstrate real progress toward the Triple Aim. Health care leaders would do well to consider innovative approaches that are working in other industries, including the tech-enabled full stack model.

Diagram Illustrating the COPD Care Pathway at Allegheny General Hospital

End-to-End Care for COPD Patients that Improves Outcomes and Lowers Costs

Allegheny General Hospital created a comprehensive solution for patients with chronic obstructive pulmonary disease (COPD) that led to improved clinical outcomes, reduced hospital admissions and readmissions, and a resultant decrease in the total cost of care.

David Blumenthal and Bob Galvin head shots

Ripe for Disruption: Why and How Big Players in the Private Sector Are Taking on Health Care

For big tech companies like Amazon, Apple, and Google, the health care sector looks ripe for disruption. Two executives working in different parts of the health care ecosystem discuss what this means for patients and doctors, including the positives and unintended consequences.

Top challenges facing chronic disease management care - insufficient time and care coordination

Care Redesign Survey: To Improve Chronic Disease Care, Change the Payment Model

Many health care organizations are reasonably effective in treating chronic diseases, but they are limited from doing better by fee-for-service payment, which remains the predominant payment model in the United States. This report serves as a snapshot in time, showing the intent of health care providers to be proactive in treating chronic disease, but limitations in their ability to address population health.

Nirav Shah head shot Stanford - AI in medicine and team care

What AI Means for Doctors and Doctoring

Physicians must hone the “four Cs” — critical thinking, communication, collaboration, and creativity — when leveraging AI as a new partner in their care teams.

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

Design Thinking

20 Articles

Taxonomy of the Patient Voice

While health care pursues the important trend of putting patients at the center of care,…

Measuring Performance of OpenNotes Initiatives to…

How a New York safety-net health system used data science to identify obstacles to OpenNotes…

Proactively Catching the Declining Patient

A coordinated effort by UCLA leaders to identify a high-cost population with chronic kidney disease…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now