Addressing the Transactional Nature of Primary Care Means Pivoting to Patient-Centered Care
Many facets of healthcare delivery are transaction-dependent and part of a rather predictable sequence: diagnostic and treatment decisions, ordering medications, tests, procedures, and referrals, administrative tasks and billing, and more. An aspect of healthcare that should not be transactional—the relationship between doctor and patient—has certainly fallen by the wayside in recent years. As a result, patients’ trust, health outcomes, and job satisfaction for the clinical care team suffer.
It’s no secret that the current state of healthcare is dismal. From widespread burnout to sharp projected physician shortages as soon as 2030, many healthcare professionals feel like chickens with their heads cut off—running amuck, just trying to stay above water and do their jobs well without losing their sense of purpose and well-being along the way.
It should come as no surprise that physicians who are burnt out (a staggering over 63% are), exhausted, and have barely scratched the surface of the trauma they endured working the frontlines of the pandemic are left with little to no energy for building meaningful relationships with patients. Instead, their patient rosters are overflowing, and they must make the most of the 10 minutes they can spend with each patient before hurrying in to see the next one. All in all, a recipe for a future healthcare delivery disaster if nothing changes.
Doctors used to make house calls and knew each family member well. Nowadays, they have to look at your file to remember your first name and may not even remember seeing you before. Why have doctors become so transactional? And can we make practicing medicine friendly and fulfilling again?
4 Reasons Doctors Are Transactional in Patient Relationships
There are a number of reasons why primary care providers in the fee-for-service model are more transactional in nature when interacting with patients. Some of these reasons include:
- Low emotional intelligence. While inherent to some, emotional intelligence and soft skills like attentive listening, empathy, and compassion must be learned by others. Medical school and residency do not focus on teaching emotional intelligence—a critical attribute for anyone working in healthcare delivery or any service-based industry—leaving many doctors without these valuable relationship-building skills that can elicit patients’ trust and improve patient-doctor relationships. One study suggests emotional intelligence actually declines in medical school. The same study also found that emotional intelligence is not only nice to have but impacts patient outcomes and that doctors must have more than medical knowledge to catalyze action from their patients.
- Fear of litigation. Sticking to stoic, black-and-white communication with patients might be an effort of self-preservation on the doctor's part to avoid being sued. 75% of physicians, by the time they turn 65, have been named in a malpractice claim. Conversely, research shows that how doctors communicate with patients is critical in whether or not doctors face malpractice suits.
- Fear of making a medical error. With medical errors up a staggering 200% among burnt-out frontline doctors, keeping communication short and simple may be a way to reduce the margin for medical error.
- Avoidance of vulnerability. Vulnerability to many doctors is akin to showing weakness; thus, they avoid showing vulnerability—or any aspect of their own humanity—to patients. This is to their detriment since research shows vulnerability is a key element of authenticity, which makes doctors more relatable and trustworthy.
Value-Based Care: Keeping Patients at the Center
If you are a physician who has steered clear of connecting on a personal level with your patients, it’s not too late to change course, and in fact, doing so can do numbers for your patient satisfaction surveys and their health outcomes. It can also lead to higher job satisfaction for physicians! Value-based care is a healthcare delivery model that keeps the patient front and center and focuses on reducing emergency room visits, hospital admissions, and costs.
Value-based care takes the status quo of fee-for-service healthcare delivery and wrings it out like a sopping washcloth. In turn, patients and physicians alike are happier, healthier, and more successful. Among the benefits of value-based care are the following:
- Building strong patient-doctor relationships because doctors have more time and capacity to spend with them instead of rushing to their next patient on an overbooked schedule,
- A renewed focus on leadership development, where physicians can invest in their own growth and development and learn new leadership skills like self-awareness, communication, empathy, conflict management, and more—keeping physicians fulfilled and energized about their work,
- Tangible impacts on health outcomes and cost reduction. Value-based care has seen the number of hospitalizations and readmissions drop significantly, keeping patients healthier and out of the hospital and incentivizing doctors to improve patients’ health instead of ordering more tests, procedures, or specialist referrals.
By keeping the core components of value-based care front and center, we can build strong patient-physician relationships and improve the quality of care, creating a more effective and sustainable healthcare system for all.
Learn more about value-based care and how ChenMed is using this model to transform primary care in our eBook, Changing US Healthcare | Value-Based Care Explained. Download your copy today.
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