FROM THE PRESIDENT by Thomas Higgins, MD, MSPH, MBA
Stronger Together for Better Care
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Consider the last time you cared for a patient with a complex illness— perhaps someone who needed input from multiple specialists or a multidisciplinary team. Chances are, you sought the expertise of some of your trusted colleagues. However, how often have you found yourself in situations where not all the questions were answered, and patients were seeking care from multiple doctors and different facilities? Suddenly, it became difficult to know what was even happening with the patient. Due to our current health care environment, this situation often leads to fragmented care, resulting from gaps in knowledge and critical insights that are not easily shared among us.
The truth is, this is such a common scenario in our profession.
Consider this: A study published in JAMA Internal Medicine of
Medicare noted that beneficiaries between 2000 to 2019 increasingly saw more specialists and a greater number of unique physicians without a significant rise in primary care contact, substantially increasing the care coordination burden for primary care providers. They found that 30 % of Medicare beneficiaries in 2019 saw five or more physicians. 1 In addition, Shrank et al. estimated that the financial losses attributed to care coordination failures ranged from $ 27.2 billion to $ 78.2 billion, and those due to overtreatment or low-value care ranged from $ 75.7 billion to $ 101.2 billion. 2
These statistics are not just abstract figures. They represent delayed diagnoses, redundant examinations and consequently, a system that does not consistently function with optimal efficacy for our patients. As physicians, we often work within the confines of our respective hospital networks, academic institutions or private practices, with limited communication streams across these boundaries. This predicament has arisen not from an unwillingness to cooperate, but from significant operational obstacles.
THE INVISIBLE WALLS KEEPING US APART Technology remains fragmented.
Different electronic health record( EHR) systems often do not communicate with each other. Even though many hospitals in the city have consolidated onto a single EHR platform, significant communication gaps persist both within the platform and with external systems. Many private practices and rural physicians still lack access to these platforms. This lack of interoperability creates major hurdles in sharing patient information efficiently and securely.
Institutional and regulatory hurdles exist.
Restrictive laws, competitive pressures among health care systems and differing administrative protocols can make cross-institutional collaboration complex and time-consuming. The very structures designed to organize health care can inadvertently create divisions.
Time constraints and a lack of dedicated infrastructure hinder our capacity for involvement.
Physicians are already stretched thin. Finding the time and the established channels to proactively connect with colleagues outside their immediate network can feel like an added, often uncompensated, burden. There is not always an easy“ on-ramp” for collaboration.
Our ingrained culture of independence sometimes blinds us.
While physician autonomy is important, it can sometimes inadvertently hinder the proactive seeking of external perspectives. We are trained to be self-reliant, and breaking out of that mindset to actively engage with others across different settings requires a conscious shift.
MOVING FORWARD TOGETHER Familiarity builds trust. Trust fosters collaboration.
The obstacles we face are not insurmountable. We possess the capability, and moreover, the imperative, to look for ways to establish better channels of communication and cooperation.
Addressing these issues starts when physicians commit to working together, or simply take the time to get to know one another. Building strong professional relationships lays the foundation for trust and open communication, both of which are essential for a unified approach. By collaborating and sharing our knowledge and experiences, we can better tackle challenges head-on.
We can also make the most of professional societies such as the Greater Louisville Medical Society( GLMS). Participating in their