In a recent article by John Lynn, he explains that ACOs are a good idea, but physicians can influence the outcomes and not control the outcomes.
In my earlier blog I started to explain that ACO success and longevity will depend on changing patient behavior. This starts with the physicians.
For decades, patients, and some nurses, have been trained to do what the doctor tells them. Don’t ask questions and take their meds on time. This model is very efficient for the physicians, but has not encouraged the majority of patients to take an active interest in their own health. It has trained them to give the responsibility to the experts and follow along passively.
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Getting patients to actively manage their own health is a training problem. Doctors are not trained to be trainers. They are trained to be healers. As John describes, this will put them at a disadvantage early in the ACO process. They will need to learn to educate, communicate, and delegate the patient transformation.
Systems will have to be created to more closely and actively monitor patient behavior. Today, the patient leaves the clinic and most doctors don’t think about them until they return. Tomorrow’s patient will leave and have to be watched in order to improve their health. There is a growing responsibility placed on the patient and there is a much bigger burden placed on the care team.
My ideal scenario here starts when the patient visits the clinic. Before he or she leaves, someone counsels them about changing diet, exercise, and other habits to prolong their life. The clinic staff gets commitment and permission to routinely check on the patient to track their progress. The patient is asked to sign in weekly, daily, or at some regular interval and update information such as their number of smokes, current weight, blood glucose level, etc. If the patient does this consistently, the clinical staff should encourage them. If the patient forgets, the clinical staff needs to reach out to get them back on track.
Everything in this scenario is about change management. Very little deals directly with healing. Patients need to change. Before they start to understand, the care team has to change. We know this can work. It has been proven in several trials around the nation.
This is change we can LIVE with.