In last week’s post, we invited readers to take a step back from Patient Leakage, and look at the term anew. Rather than being used merely as a synonym for patients who leak due to physician referrals, patient leakage needs to encompass any instance when a patient is lost to a competing hospital system.
To fully understand this redefined, larger umbrella of patient leakage, it’s important to first address that well-known, glaring symptom: doctor referrals. The complex issue is part-systematic, and part-philosophical, but it is entirely leaky.
How patients get referred and why it’s considered leakage
Although patient experience scenarios are endless, walking through the process of a doctor referral will help paint a fuller picture of the problem.
First, a patient experiences a health trigger; a patient’s hand feels like it might be broken, or he or she isn’t breathing normally, or maybe there was an accident that demands emergency attention. No matter the trigger, patients are (typically) not doctors, and they often estimate the health problem incorrectly.
Sometimes a patient underestimates the health trigger, booking an appointment with his or her primary care physician with plenty of lead time, when the root problem really needs more urgent care. Other times, a patient overestimates the health trigger and seeks emergency health care, when the root problem isn’t actually that dire. In either scenario, the patient will usually end up seeing his or her primary care physician (PCP) anyway, and this is where the cracks in the process start to show.
For instance, if a patient feels like his or her shoulder might be broken, that patient could either end up running to urgent care or waiting to see his or her PCP right off the bat. But let’s stick with the PCP scenario for the sake of sanity. The PCP will do one of two things, he or she will dig into their professional memory bank and pull out a trusted name (which may or may not be in-system), or the PCP will send the patient over to the front desk. Either way, it is quite typical for a specialist name, schedule, and contact info to be pulled from… a binder. That’s right; an actual binder.
This is where the doctor referral leakage problem is systematic, and concerns a simple lack of quality tools. The limitations of a binder are obvious. “Paper” does not offer live scheduling, nor does it allow physicians the opportunity or space to market themselves with materials like mission-statements, values videos, or descriptions of procedure expertise. It’s usually eerily similar to a phone book. To be fair, some practices and hospitals have upgraded to outlook-style calendars on computers, but the vast majority of these systems are still quite outdated.
Providers and doctors also need better internal tools so they can communicate with each other. Due to a lack of a solid communication tool, some physicians reach for the closest reliable communication tool, which is right in their own pockets: their smartphones. Texting patient information breaks HIPAA and is illegal, but it’s not surprising that some doctors take the risk because quality communication between physicians, which leads to better patient care, is vital.
Let’s continue with the journey of our patient with the bad shoulder, who has now stood at the front desk, and watched as a nurse’s index finger scanned what looked to the patient like a phone book page, and called to schedule his or her appointment with a specialist (who may or may not be in-system). Chalk up one potential leak.
After that, it is quite possible that the specialist referred to actually refers the patient to a second specialist. This could happen if it is left shoulder surgery that’s needed, and there is a surgeon who specializes in left, not right, shoulder surgery… yes, it gets that specific! The doctor referral rabbit hole can go that deep, which means the patient leak is more like a water slide out of the original PCP’s system.
Two solutions that will inspire patient “keep-age” in the doctor referral process
The good news is that with the right tools and objectives, doctor referrals don’t have to contribute to patient leakage. When done right, doctor referrals can even inspire patient keep-age.
1. Providers & Doctors Need Quality Tools
Binders and telephones still have their uses, but when it comes to a patient’s health, care needs to be at its finest. Providers and doctors need back-end tools that have robust, customizable search and scheduling functionality. Capabilities like live scheduling and informational materials lead to more efficient care for the patient, as well as better transparency. The tools need to also include HIPAA-compliant communication between physicians. This way, the care a patient receives won’t be so reliant on that patient’s interpretation of his or her symptoms, something that patient typically has to recite to every physician he or she visits.
2. PCPs Need To See Themselves As a Patient’s Health “Designer”
Consider a consumer visiting a shopping mall who wants to upgrade their home aesthetically. He or she will visit different shops, thinking that by purchasing every attractive piece he or she comes across the house will look better. This is often not the case, because what they really need is an interior designer, a holistic expert, to tie all of those pieces together. In healthcare, patients receive their care piecemeal, and they need an expert to tie it all together so that every piece contributes to an overall healthier life.
This is a philosophical shift that PCPs need to implement. Rather than merely trying to churn out patient visits for short-term income, PCPs need to start investing in their current patient-bases to nurture long-term loyalty. Designing care plans for patients, even if it includes a short-term leak will not only keep those patients as customers, but will also provide the utmost healthcare for those patients, and they will want to come back to that PCP. Chalk up one to patient keep-age.
Come back next week to see how Patient Experience is a top contributor to Patient Leakage in the final installment of our 3-Part Series!