Care After Covid by Shantanu Nundy

Author:Shantanu Nundy
Language: eng
Format: epub
Publisher: McGraw-Hill Education
Published: 2021-05-15T00:00:00+00:00

REALIZING THE VISION

As the Human Diagnosis Project pilot example showed, realizing the vision of collaborative care will require fundamental changes in culture, payment models, and care delivery.

Embracing the Idea That Healthcare Takes a Village

The shift to collaborative care will require us to free ourselves from the notion that healthcare is what happens between a single doctor and a single patient. From the first days of medical school, the idea of the physician as an individual hero is deeply ingrained in the identities of physicians. We hail the doctor who gets the diagnosis right, the surgeon who makes the lifesaving cut, and the ideal of being somebody’s doctor.

Breaking the mental stranglehold will not be easy. But it may also be less difficult than we think, as I learned at Accolade. When I joined the organization, our care model for over 10 years was to “surround” the doctor visit: our nurses called members before they saw the doctor to help them prepare for the visit and then called them immediately after the visit to help them with next steps. When I started, I had a radical idea: What if our nurses could actually be “in” the visit? By asking patients to call us during the visit and put us on speakerphone, our nurses could listen in on the visit and give patients and doctors extra support in real time. As we prepared to test this idea, a major question lingered: Would doctors actually agree to it? Our worry was that doctors may covet their one-on-one time with patients and may be uncomfortable with a nurse who they don’t know joining the conversation. The answer, however, from a pilot we conducted was a resounding “yes.” Later, during the pandemic, when my mom got kidney stones out of town and I couldn’t travel to be with her, I used the same approach to be “in” her visits. Time and again, I was pleasantly surprised when busy doctors, from ER physicians to urology specialists, agreed to dial me in so I could ask questions over the phone.

Part of the reason, I suspect, is that collaborative care has benefits for doctors, too. It’s hard to talk about innovation and change in medicine today without acknowledging the problem of doctor burnout. The causes are multifactorial, but what I’ve seen firsthand is that collaboration has a role in restoring joy to clinical practice. Doctors who work in multidisciplinary clinics often say they’ll never go back to solo practice. Attending doctors in academic medical centers look forward to case conferences and rounds. And I know firsthand from my clinic that patient care is more rewarding when family members and loved ones are involved.

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