Over the last couple weeks, experts and commentators alike have reflected on the last decade’s trends and prognosticating on 2020’s trends in healthcare. The themes, to name a few, revolve around pricing transparency, behavioral health access, advanced alternative payment models, and the 2020 election results.
Inherent in both the trends and the transformation we all desire, is the bread and butter business of delivering care - of which the two most important constituents are patients and provider(s). Successful collaboration, connection, and communication between patient and provider is foundational to achieving the desired improvements in care experience, costs and outcomes these trends hope to impact. Yet, what feels missing from the dialogue are specific tools and approaches focused on cultivating the patient-provider relationship.
So, how does any of this relate to making gumbo? Well, primarily it’s because the holidays are over and my kids and I are fighting over the last bowl! But it’s also because the success of any gumbo is predicated on the collaboration of key ingredients. But before I continue to deconstruct this metaphor, let’s level set with some definitions. For the purposes of this discussion:
Patient – an individual (can include primary caregivers too) who consumes a healthcare service for the purposes of getting well and/or staying healthy.
Provider - the licensed clinician - usually a physician AND the clinical and administrative team on the ground level (patient facing) that provide episodic and ongoing healthcare services.
On to the gumbo:
Gumbo – a traditional stew served in Louisiana made with strong stock, seafood, meats, seasonings. Natives of Louisiana have strong feelings on how and what constitutes a gumbo!
My grandmother, Ethel B. Morgan (may she RIH) was an amazing Creole cook, and often I was her “sous” chef for holiday or large family gatherings. When making gumbo, she would say there were 2 secrets to gumbo – the first, a great gumbo starts with a great roux. The roux, for those unfamiliar, is made up of butter (or a fat) and flour – 2 simple ingredients. However, the proper melding of those 2 ingredients makes all the difference in the outcome of the dish. It’s the foundation on which the color, flavor, thickness and added ingredients all depend. One can have the best seafood, meats and seasoning and if the butter/flour isn’t combined well, your gumbo will look and taste like swamp water!
In my opinion, there is a similar application in healthcare. Core to the healthcare system we are driving to become is the foundational relationship between patients and providers. Ensuring patients feel connected to their providers, their providers have easy, convenient means to communicate and collaborate with each other and with their patients are all a core element to the transformations we hope to achieve in this decade.
Now just as in a gumbo, the meat, seafood, stock and seasonings also are the difference between a delicious stew or a bland soup. Technology advancements, like the EMR, engagement apps and web portals enhance and improve our health care experience. Advancements in payment methodologies incent providers to invest in team based, whole person care delivery models. The focus on behavioral health makes everyone happier and healthier, and finally financial transparency reminds us that patients are a consumer with competing needs for a limited resource and providers have a responsibility to provide care accordingly. All important layers or flavors of or healthcare “gumbo”.
So where are the opportunities to improve the relationship and thereby outcomes?
At a high level, there are several key elements to ensuring a good patient/provider foundation (this list is illustrative, not exhaustive):
Leadership consistently speaks to and incorporates the importance of patient experience and provider support in communications and action plans.
Workflows, processes, and systems are designed and/or redesigned with provider input and with the patient experience in mind.
Measure and report on metrics beyond traditional patient and provider satisfaction scores, for example – how long does it take to see specialists – from referral to appointment?
Stop assuming and – ASK – People like to talk about their experiences – learn where to impact from listening.
Ongoing focus – this isn’t an initiative. It’s as important as quality work – staff accordingly.
Get outside help – learn from others – no need to reinvent the wheel and an outside perspective can highlight key areas you may be blind to.
All of the advancements in healthcare add depth of experience and “hopefully” drive healthier outcomes in the “gumbo” of our healthcare ecosystem. However, as we look to the next decade and reflect on the past 10 years, investments in patients and providers is as foundational to success as the butter and flour to a great gumbo.
Bon Appetit!
Here's a visual of the last bowl...
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