Friday, July 23, 2010
CXO
This post by John H. Schumann, FACP, originally appeared at GlassHospital.
A classmate of mine was recently given a job title I'd never heard of: CXO. He's been made the Chief Experience Officer at a large Midwestern medical center--one of the ones that's been touted in the health care reform debate as a paragon of effective care delivered in an efficient and [somewhat] cost-conscious manner.
I'd seen the announcement about his promotion, and didn't really understand what it meant. So I contacted him, and this is what he emailed back: "I was appointed to this role in July. I report to the CEO. We have the highest level commitment to patient experience. I get all of the resources I need. [The CEO] has made employee satisfaction/engagement, and patient experience the two highest institutional priorities. These two issues are linked completely. Can't have satisfied patients without satisfied employees!
"I am partnered with the Executive Chief Nursing Officer and together we run the office of patient experience. ~65 employees. We realized that it is really about the docs and nurses. [She] and I have adopted our Chief Human Resources person as the third wheel of patient experience, because of the engagement / satisfaction component. Our department includes a variety of programs. We have an executive director who runs the operations. As CXO I sit on the executive team and too many committees to name."
Hang on a second. Let me pick up my jaw.
My old classmate has sixty-five employees in an "office of patient experience." This tells you a couple of things:
1. The medical center that he works at is sizable and has ample resources.
2. They take customer (patient) satisfaction very seriously (and couple it with employee happiness, interestingly). Hmmm ...
Being the CXO means that my friend has become the face of his organization for all patients and their experiences at his medical center. Since in his role the buck stops with him, he's fully empowered to make change. No doubt it helps to have direct access to the CEO, whose vision helped my friend attain his position.
This CXO role got me wondering: How can I get sixty-five employees to do my bidding?
Actually, what I'm really wondering is what the consequences of such an office are. What if wewere fully empowered to serve our patients the best way we knew how? Or still yet, in ways we've not yet even conceived of?
Here's what I came up with; I'd love to hear your ideas:
1. Scheduling that works.
When patients call to see their doctor, being told that my next available appointment is in 8 weeks is not helpful. Patients should be able to see the template online and pick a spot, just like a seat on an airplane.
2. Transparency.
Instead of being told, "The doctor will be right with you," which could mean anything from now until 30 minutes, let's have some honesty or at least give patients more accurate information. Restaurants can do this.
3. Prices.
This is an easy whipping-boy for lots of health reformers and pundits. But what other industry would survive where the service providers (doctors) have no clue about the real world prices of the tests and products they're recommending? Believe me, I've asked, and the runaround I get on this one is amazing. So it's not my fault, entirely.
4. Products and services.
Why do we treat the medical record like some ancient biblical text? "You want a copy of your records? That'll be 20 cents/page, take 5 business days and require you to stand on a stack of holy bibles to prove your identity."
I understand the need for patient confidentiality, but our system is corrupted: I'm as guilty of this as any doc. Our records are to please the dictates of billing/coding and quality assurance. They're usually at least somewhat in gibberish, and we almost never give the patient a copy of what we just did with them.
Wouldn't it be nice to have a printout of our consult? Results of your tests? Doctors have gotten better about giving out lab results, to be sure, but shouldn't you be able to somehow get online and check your own results and then contact us with your questions? Or at least be able to access them once the doctor has 'reviewed' them?
I'd like to look at this post as the start of a wish list for 21st century medicine. From your keyboard to my ears. Or screen. Or eyes. I have a lot more ideas, but I hope this gets the ball rolling.
John Henning Schumann is a general internist in Chicago's south side, and an educator at the University of Chicago, where he trains residents and medical students in both internal medicine and medical ethics. He is also faculty co-chair of the university's human rights program. His blog, GlassHospital, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people that inhabit them.
Labels: Glass Hospital, guest post, hospital leadership, patient care, patient satisfaction
posted by John Schumann, M.D. at
8:00 AM
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Members of the American College of Physicians contribute posts from their own sites to ACP Internist and ACP Hospitalist. Contributors include:
Albert Fuchs, MD
Albert Fuchs, MD, FACP,
graduated from the University of California, Los Angeles School of
Medicine, where he also did his internal medicine training.
Certified by the American Board of Internal Medicine, Dr. Fuchs
spent three years as a full-time faculty member at UCLA School of
Medicine before opening his private practice in Beverly Hills in
2000.
David Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally renowned
authority on nutrition, weight management, and the prevention of
chronic disease, and an internationally recognized leader in
integrative medicine and patient-centered care.
DrDialogue
Juliet K. Mavromatis, MD, FACP, provides a conversation about
health topics for patients and health professionals.
Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more
than a decade and is an Associate Professor of Medicine at an
academic medical center on the East Coast. His time is split
between teaching medical students and residents, and caring for
patients.
Everything Health
Toni Brayer, MD, FACP, blogs about the rapid changes in science,
medicine, health and healing in the 21st century.
FutureDocs
Vineet Arora, MD, FACP, is Associate Program Director for the
Internal Medicine Residency and Assistant Dean of Scholarship &
Discovery at the Pritzker School of Medicine for the University of
Chicago. Her education and research focus is on resident duty
hours, patient handoffs, medical professionalism, and quality of
hospital care. She is also an academic hospitalist.
Glass
Hospital
John H. Schumann, MD, FACP, provides transparency on the workings
of medical practice and the complexities of hospital care,
illuminates the emotional and cognitive aspects of caregiving and
decision-making from the perspective of an active primary care
physician, and offers behind-the-scenes portraits of hospital
sanctums and the people who inhabit them.
Gut Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the
University of North Carolina School of Medicine, and the Program
Director for the GI & Hepatology Fellowship Program. He
specializes in diseases of the esophagus, with a strong interest in
the diagnosis and treatment of patients who have
difficult-to-manage esophageal problems such as refractory GERD,
heartburn, and chest pain.
I'm dok
ACP Member Mike Aref, MD, PhD, ACP Member, is an academic
hospitalist with an interest in basic and clinical science and
education, with interests in noninvasive monitoring and diagnostic
testing using novel bedside imaging modalities, diagnostic
reasoning, medical informatics, new medical education modalities,
pre-code/code management, palliative care, patient-physician
communication, quality improvement, and quantitative biomedical
imaging.
Just Oncology
Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.
KevinMD
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites
for influential health commentary.
MD
Whistleblower
Michael Kirsch, MD, FACP, addresses the joys and challenges of
medical practice, including controversies in the doctor-patient
relationship, medical ethics and measuring medical quality. When
he's not writing, he's performing colonoscopies.
Medical
Lessons
Elaine Schattner, MD, ACP Member, shares her ideas on education,
ethics in medicine, health care news and culture. Her views on
medicine are informed by her past experiences in caring for
patients, as a researcher in cancer immunology, and as a patient
who's had breast cancer.
Prescriptions
David M. Sack, MD, FACP, practices general gastroenterology at a
small community hospital in Connecticut. His blog is a series of
musings on medicine, medical care, the health care system and
medical ethics, in no particular order.
Reflections
of a Grady Doctor
Kimberly Manning, MD, FACP, reflects on the personal side of being
a doctor in a community hospital in Atlanta.
Technology in (Medical) Education
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in
education, social media and networking, practice management and
evidence-based medicine tools, personal information and knowledge
management.
White Coat Underground
Peter A. Lipson, MD, ACP Member, is a practicing internist and
teaching physician in Southeast Michigan. The blog, which has been
around in various forms since 2007, offers musings on the
intersection of science, medicine, and culture.
ACP Internist and ACP Hospitalist also contribute to and draw upon content from Get Better Health, a network created by Val Jones, MD, to support and promote health care professional bloggers, provide insightful and trustworthy health commentary, and help to inform health policy makers about the clinician's point of view on health care reform, science, research and patient care.
Other blogs of note:
American
Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine
publishes original clinical articles of interest to physicians in
internal medicine and its subspecialities, both in academia and
community-based practice.
Clinical Correlations
A collaborative medical blog started by Neil Shapiro, MD, ACP
Member, associate program director at New York University Medical
Center's internal medicine residency program. Faculty, residents
and students contribute case studies, mystery quizzes, news,
commentary and more.
db's Medical
Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating
medicine and the health care system.
Interact
MD
Michael Benjamin, MD, ACP member, doesn't accept industry money so
he can create an independent, clinician-reviewed space on the
Internet for physicians to report and comment on the medical news
of the day.
PLoS
Blog
The Public Library of Science's open access materials include a
blog.
White Coat Rants
One of the most popular anonymous blogs written by an emergency
room physician.
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