The report cards for clinicians in our accountable care organization (ACO) came out recently, and boy, did we fail miserably.
Looking through the 59-page document, some of our best doctors who have attributed Medicare patients in the ACO—people I would trust with my life and the lives of my family members—look like terrible doctors on these report cards.
From the looks of it, none of us are providing much care at all. We’re not documenting patients’ medicines in the EHR, screening for fall risks, giving anyone any vaccines, making sure they get colon cancer screenings, and ensuring they get their depression under control.
Not surprisingly, senior leadership is now coming at us, trying to make sense of how this could possibly have happened and looking for quick answers to improve the next report card.
But we all attended the class about these processes. I think we know by now that the boxes just aren’t going to get clicked.
Trust me, trust us, these are all incredible doctors. They’re taking incredibly good care of complex and challenging patients in a complex and challenging healthcare environment, with fewer and fewer resources every year.
Believe me, we’re vaccinating our patients, we’re addressing their depression, and we’re working like crazy to get their blood pressure under control.
The whole concept of the patient-centered medical home, this idealized vision of a grand team taking care of our patients, is desperately in need of some ancillary services—not only to do all this extra work and document it in the right places in the chart, but also to actually help ensure that this translates into the best care for our patients.
This is true of every click box. Clicking the box means nothing, if the care isn’t there, if the resources aren’t there, at the other end.
Without this, we will all just continue to fail. And I, for one, find that unacceptable.
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Fred N. Pelzman, MD, of Weill Cornell Internal Medicine Associates and weekly blogger for MedPage Today, follows what’s going on in the world of primary care medicine. Pelzman’s Picks is a compilation of links to blogs, articles, tweets, journal studies, opinion pieces, and news briefs related to primary care that caught his eye.