That's Not Physician Work

For the last 7 years our team has been working together toward a common goal. A strong and safe Patient Medical Home, where our patients are known to us, we know who their family doctor is, and we can provide continuity with their provider (best) or within the provider group (second best). Part of a strong Patient Medical Home is the provision of best practices, including screening.

Over the last 6 years our improvement team has met toward the common goal of choosing a project and using the team to carry out the project.

Some of these projects have included; increasing mammogram rates, increasing FIT test uptake, and increasing our Pap Smear screening rate.

We have, where possible, passed these reminders and follow up to the non-physician members of our team.

THEN COVID.

Right before the COVID-19 pandemic truly started we were given a “panel manager” – a medical assistant to help us keep our patients known (panelled) and continue the Patient Medical Home projects. Screening became optimized instead of just opportunistic. It started with onboarding to orientate her to our best processes and then screening duties were stepwise added to her day.

Then COVID and a provincial request to hold any non-essential visits and screening interventions.

Fast-forward 9 months and we have had a change of staff in that role AND a HUGE backlog.

This was not fully appreciated by the team until yesterday. The assumption was that everything was going according to plan.

BUT one half time assistant cannot handle a nine-month backlog.

Here is the interesting part: the team member working with the Medical Assistant saw the overwhelming task of the backlog and determined that the easiest solution was to put notifications in the patient chart and get the doctors to resume screening.

Many of you may be in this position now, screening is currently your job.

But screening is a formula, a specific flow chart, it can be delegated within a robust effective team/clinic and actually – your team can do a better job than you!

WHAT? They can do it better than ME?

Yes. A team member who is taught and empowered to provide screening can be more thorough than you.

SO WHAT NOW?

This is an opportunity.  As a TEAM we can figure it out.  It will mean getting together, identifying the problem and looking for the most simple solutions.

I have ideas on how we can do this; however, I don’t want to be prescriptive.  What if I’m not around the next time this happens? How strong is our team really?  What if I don’t actually know the correct solutions and my team can, again, do it better than me!

THIS TURNED OUT TO BE A BIG PROBLEM....A huge backlog of screening to be solved.

Once we know how to do it we may just be able to use the strategies we come up with to solve the other screening problems that we haven’t yet tackled!

We may come up with solutions that are useful for other teams who are earlier in their journey than us.  An opportunity to delight in seeing everyone’s skills come together to solve a problem.

So – I encourage you to start to consider what you are doing that could be tasked to your team and who would be on your team.

Let the non-physician work be done by the team who can do it better than you and spend time on your zone of genius.

Have a great week everyone!

xx Sarah, the Charting Coach