Hey everyone! This past summer break has been absolutely glorious, and sadly, it’s about to come to an end. That means back to the classroom and clinic–both of which are great–but can be more restrictive time wise.
For the past 5 weeks, I wanted to get a diverse experience in medicine, since there is so much to explore. So I took on two experiences: one wet lab research experience in trauma surgery, and the other working with a business development team for an urgent care clinic. Two very different experiences, but both absolutely incredible. In the next post, I’ll talk about my experiences working in trauma. Today, I wanted to reflect on the intersection between business and healthcare.
I know what some of you may be thinking: “You’re going to MEDICAL school. You want to help PEOPLE. Why would you want to work for a business; isn’t it the antithesis of medicine? Don’t doctors hate the complications that come with the business of medicine, like insurance companies and unnecessary policies?” Believe me, I’ve thought all of these things. It’s why I wanted to pursue trauma, where the last thing on my mind should be business. But as I’ve gone through my first year of medical school, spent many hours in clinics and the OR, and even having been a patient for a short stint, I can tell you just how influential the business of medicine is. Insurance, quality improvement, outcomes research, pharmaceutical, access to care–the list goes on and on. So, rather than fight against it, I’d check it out.
It all started my first term of medical school, when I took two non-science classes: Medical Care and the Corporation (MCC), and Patients & Population Health (P&P). The first one, MCC, I was surprised at just how much opportunity there is to expand healthcare and to ultimately better health for millions of individuals. Each week we brought in different CEOs, presidents, and other executives to share how their companies are influencing the access to healthcare for millions of Americans. While sometimes we medical students were skeptical of their commitment to health over the dollar bill, we saw how the mindset of business vs. medicine does not have to be a zero-sum game. By improving access, affordability and quality–central tenants for any successful business–we can make the field of medicine better.
So this summer I interned for a burgeoning urgent care clinic across Portland. Urgent care clinics are a recent outcome from a business mindset. Why send patients who present with non-emergent symptoms to an ER, which is already overwhelmed, costly and can often be far away? When a patient has a persistent cough or a lingering rash, and they can’t get into their PCP, shouldn’t there be someone who can see them sooner rather than later? That’s the role of an urgent care provider.
And when I first entered one of the clinics I was working for, I knew this wasn’t designed by a doctor or nurse. Entering the clinic, everything was orderly, clean and had a clear purpose. Tablets were at the door where you could sign in. Signage was clear, the space was open, wait times were projected on a color-coded screen, and the staff had very clear roles. Customer service was just as essential to the patient’s health. To me, this makes sense. Being sick is an emotional time and if the provider can help console you while they treat you, I call that strategic bedside manner.
My role at the clinic was to identify ways to find patients who may not be getting in to see a healthcare provider when they need it most. Working with the C-team (CEO, COO, president, CMO, and many others), we identified that missed phone calls often times represent a significant population of patients not getting medical attention. In fact, about 25% of all phone calls to the clinic were related to symptoms, and about half of these calls were new patients. If we were not answering 100% of these calls, this could mean a patient does not receive immediate medical attention. Looking through and analyzing data (much like a scientist), I drafted a proposal to create a modified call center that focuses on preventing missed calls.
The work, while very different from medical school classes where we’re memorizing countless bones, blood vessels and biochemicals, is pretty similar to being a physician. You identify a chief compliant (patients not receiving medical care), look for symptoms to corroborate, identify a root cause (missed incoming calls), identify a treatment plan (propose a new strategy to answering calls), identify implications for the plan (How much does this cost? How much does this save? Who will do this work?) and follow up accordingly.
Our school has a joint MD/MBA program that looks at these similarities, and I’m looking into it. It’s compelling to see how it’s not just doctors and nurses who are committed to health and healthcare. If anything, it gives me hope for our changing healthcare climate.