Does anyone remember not needing an appointment to visit the doctor? It’s hard to believe that as recently as the 1950s and 60s, going to the doctor appointment-less was not only permissible, it was the standard. Today, we all too often make appointments to visit the doctor, only to spend a significant amount of time in a waiting room and a relatively insignificant amount of time in actual doctor-patient consultation.
A primary care physician’s central goal is the delivery of coordinated and comprehensive care for their patient, and this requires a broad spectrum of medical knowledge, effective use of the local health care system, and attention to both the “big picture” and the details of a patient’s life and health. However, specialist physicians serve an increasingly pivotal role in modern medical treatment.
The ability to consult with a specialist is not only of increasing importance to the patient, but also the primary care physician. For the patient, interactions with a medical specialist will help them understand the specific illness or disease they have contracted, and will position them to make more informed decisions regarding the course of treatment they will undergo. For the primary care physician, the frequent interaction with medical specialists provide a form of continuing education that serves to broaden their understanding and knowledge of their patients’ illnesses and diseases. It’s a clear win-win, provided that all of the participants are involved.
With the numbers of medical specialists in many high risk fields like high-risk pregnancy, behavioral health and neurology in short supply in many metropolitan regions, it is of paramount importance that we find ways to leverage these scarce specialist resources across the widest number of patient cases possible. Traditionally, specialist consultations involved either a patient and a specialist, or a primary care physician and a specialist. Through modern telecommunications, it’s now possible for the patient, the primary care physician, and the specialist to engage simultaneously to discuss a patient’s illness or condition and possible treatment options.
And of course, it’s not just about the people – it’s also about the data. Aggressive routing and storage technologies can permit the availability of medical imagery (MRI, PET, CAT scans) from remote locations. Real-time streaming from specially configured medical devices can permit real time interactive clinical consultation.
Large hospital chains are investing millions to provide remote medical consultation services across their network of hospitals, care centers, and doctor offices with the hope of providing access to the few specialists they have for certain difficult medical conditions. Primary care provider networks are even taking it to the next level by providing patient follow-up consultations via secured Internet platforms that allow the patient to consult with their primary care provider from the comfort of their home or office.
Physicians have been traditionally trained to first diagnose, and then prescribe treatment – the two central activities in the delivery of health care. While there are steady achievements in the areas of researching and understanding illness or disease, inventing new medical devices, or devising new prescription protocols to treat illnesses, analyzing physician time as a resource has received surprisingly little attention. However, the amount and quality of the interaction between patient and physician has been shown to have statistically relevant impacts on more than patient perceptions of quality, but also measurable improvements in both health outcomes and patient loyalty.
Improving patient engagement in the health care decision process, combined with the effort to link monetary incentives to post-care outcomes may sharpen the attention for the physician to not only improve the amount and quality of communication with their patients. Primary care physicians should also make use of the technology at their disposal to involve available specialists in their efforts to diagnose conditions accurately and early and prescribe the correct courses of treatment for their patients.