Understanding Population-Based Health Care to Engage Physicians
Wow, just writing this title excites me. Partly since I have such a passion for bringing together practitioners and patients for better health outcomes. But mostly because when we add a powerful mission that inspires real action that is based around population health management, I believe we can make some real progress in creating healthier and happier lives. To me, that’s exciting because what it takes is us working together to implement a system that engages patients to become participants in their health. And this, my dear heart-centered friends, is where you as a holistic and wellness practitioner enter the traditional health care scene with your subset of skills and heart-centered characteristics that can lead health care teams toward new clinical benchmarks never before experienced in a clinical setting. Yes, that’s a bold statement but one that I am convinced is not just possible but necessary.
So how does one undertake such a task? How can integrative practitioners not only be viewed as a viable part of the health care team but as a real contributor to the patients’ health outcome?
I see population-based health care as a type of stone soup. If you remember the original folktale, villagers are tricked out of their greed and fear and into sharing and enjoying life with their neighbors. All thanks to a soup that didn’t even exist… until everyone, unsuspecting even to themselves, contribute their one and only ingredient; that alone wouldn’t amount to much. If each of us is truly interested in spreading our mission in which we all share the same outcome goals of healthier and happier people, then we must be willing to participate as a team. We must be willing to see, not only how our own “ingredient” brings value but how each member of the team brings value to the ultimate outcome of restored health and happiness. We must move past the “we against them” mentality that has plagued our health care system. We can no longer afford to see the split between social determinants of health and the physical manifestations of disease. The lifestyle medicine movement is already verifying the need to include what many holistic practitioners have known for decades, that individuals are not separate from their thoughts, feelings, beliefs, and habits which have a direct impact on health outcomes. We are not so different and clinicians are more open than ever to understanding all determinants of health.
There are several things that we must take into consideration first before we take on such a task and one of the biggest challenges I see from holistic and wellness practitioners is the willingness to speak and understand the same language as our clinical colleagues. It would be like moving to a foreign country without knowing the language. This most often happens because in our passion and excitement for giving witness to our mission, we tend to hyper focus on the techniques of our modalities rather than on the intended health outcome. Can you imagine a surgeon giving the details and methods of using a scalpel to cut into our flesh? Ugh, who wants to hear that but another colleague? All I want to know is if I’ll get better and how! Not the details of the technique. Focus on the health outcome that your modality offers which in turn is your mission!
The next thing is that we must step up and position ourselves and our scope of practice so it’s aligned within the standards of care for a specific disease state. For example, if you are a certified or licensed massage therapist and you have additional certification in lymphedema treatment then you would focus on chronic conditions that are known to cause lymphedema such as cancer treatments or diabetes among others. Obviously, your scope of practice must align with the chronic conditions in which you are certified. I’ll be discussing in greater detail how to position your scope of practice to build stronger relationships with clinicians in future postings. But for now, it’s important to know that not being clear on how your scope of practice aligns with standards of care for a specific disease state, may be the reason for your difficulty in getting clinician referrals or collaborations.
Lastly, we need to get a clear understanding of the “lay-of-the-land,” of not only within the clinical health care setting but the new payment system that rewards doctors and hospitals for improving the quality of care. Pay-for-Performance is a term for initiatives aimed at improving the quality, efficiency, and overall value of health care. These arrangements provide financial incentives to hospitals, physicians, and other health care providers to carry out such improvements and achieve optimal outcomes for patients.
Pay-for-performance has become popular among policy makers and private and public payers, including Medicare and Medicaid. The Affordable Care Act expands the use of pay-for-performance approaches in Medicare in particular and encourages experimentation to identify designs and programs that are most effective. I see this as another opportunity to expand your mission by demonstrating how you can help increase quality measures, efficiency in care, diminish gaps in care, and provide value in optimal health outcomes.
Therefore, in part 2 of this posting, I will clarify what we mean by population-based health management within the constraints of an integrative health practice. In fact, we may need clarification on several terms that are now being used in the health care settings such as integration, quality measures and how understanding these key components within clinical settings can help establish you as a viable member of the health care team and secure your position as the expert in your field.
Until then, be well my friends as you help move people towards the truth of well-being with hope, love and laughter!