Dr James Whitfill on Engaging Physicians and Patients in ACOs

Accountable care organizations have to work more on engaging physicians in meaningful leadership roles and should focus on learning about patient goals, said James Whitfill, MD, chief medical officer of Scottsdale Health Partners.

Transcript (modified)

How can ACOs do a good job of engaging their physicians?

So physician engagement, while it’s something that everybody talks about, is actually pretty hard to do. A couple of things that we think that have been helpful for us in terms of achieving meaningful engagement is first having real physician leadership. So not just putting physicians in a place where they have a nominal voice, but in fact where they’re actually leading the organization.

At Scottsdale Health Partners, 90% of all our governance positions are filled by physicians. So they have a meaningful role in driving where the organization goes. And then I think making sure that they understand that this is a very different way of practicing, and this is a hard shift, it’s a hard shift for all of us to move from a fee-for-service world to a fee-for-value world.

So we do a lot of education, not just formal education but by physicians being in leadership roles they themselves have to learn, and sort of incorporate these new concepts of value-based healthcare.

How much do patients understand or know about the fact that they are in an ACO? And to they need to know?

So with our patients I don’t think we spend very much time talking about being in an ACO, but we spend a lot of time trying to figure out what their health goals are. Oftentimes, and this is surprising to us as physicians, patients are focused on their own goals, not my goals. And so if I don’t understand what their goals are, whether they are to be out of pain, or if they’re worried about their rent, or how they’re going to care for their children, those goals get in the way of them being able to focus on their health goals.

So we actually spend a lot time trying to understand what those barriers to care are, meeting the patients where they’re at, and then coming up with plans that first meet their goals and then we can mix in our health goals.