Physician Advisors Influence Better Patient Care

by Stefani Daniels, Managing Partner
Published on Jul 26, 2018

A growing body of research affirms the significance of physician-case manager collaboration for the delivery of quality patient care and better health outcomes. The collaboration is a joint venture and integrates every member of the care team through open communication, and shared decision making.

When it comes to low-value interventions,  practice variations, or under- or overutilizing resources, some physician advisors (PA) say too much emphasis has been placed on castigating individual physicians and not enough on using the best available evidence to improve a whole healthcare delivery system.  Those PAs are leading their organziations away from the "I gotcha" model of utilization management and performance improvement toward a broader, patient-centered and data-driven method that values and rewards the very thing physicians do - good patient care.  Yet, many PAs will agree that one of the tougher parts of their job can be convincing physicians that while performance improvement may have some traits in common with resource utilization, its ultimate goal is to enhance quality, not cut costs (although it often does that, too). 

Physician Advisors use an arsenal of tools to bring even the most independent minded physicians into the era of accountability.  They include a more consistent use of evidence based guidelines that considers the latest medical research, creating a supportive culture, utilizing electronic decision-support systems, easy access to both in-house and external data, and collaborating with case management leaders to design a model of care coordination that can demonstrate better patient outcomes.

A value-based care coordination program is one strategy to influence physician performance improvement.  It quietly creates a culture that supports patient centered care across the continuum and positions the case manager as an advocate for every stakeholder. Hospital case managers understand that to optimally coordinate care for selected patients, they must be present and available to partner with the physicians who are caring for those patients.  That partnership is essential to empower the case manager to promote the use of evidence based guidelines, identify guideline variations and how they may affect patient care outcomes, share information from other care team members, and refer to the aggregation of data that reflects the physician's practice patterns.  It also means that the case manager is pro-actively advocating for the patient and family to ensure that their preferences for care are understood, supported by the physician, and within their means. 

The PA is key to making sure that these initiatives are designed with patient care in mind and truly perceived by physicians as improving care. If they are seen as cost-saving or revenue-enhancing ploys, they will not be greeted with much enthusiasm.