A recent article in Crains Detroit Business reported the results of a national physician survey conducted by The Doctors’ Company, a large malpractice insurer. According to the survey, 10% of physicians nationally report plans to convert their practice to a “medical home” model. But, that number was 27% for Michigan. Nationally, only 14% of physicians are interested in joining an accountable care organization (ACOs). But, in Michigan this number was 25%.
Why are Michigan doctors twice as interested in medical homes and accountable care?
Steven Newman, M.D., president of the Michigan State Medical Society, attributed it to the fact that Michigan physician organizations have been working on this for a long time. I was proud to see that he called out Blue Cross Blue Shield of Michigan as being one of the drivers. BCBSM’s Patient Centered Medical Home designation program has been going on for 4 years. Its Physician Group Incentive Program (PGIP) has been going on for 8 years. Its Collaborative Quality Intiatives (CQIs) have been going on for more than a decade.
Unfortunately, these things take time. Fortunately, in Michigan, we started a long time ago.
My former boss, Tom Simmer, MD, CMO of BCBSM, has consistently emphasized the importance of using time as a lever of change. And, he insisted on staying positive and respectful, focusing on building energy that can “catalyze” change by physicians and other health care professionals. It seems to have paid off in terms of physician interest in medical home and accountable care transformation. Although it is difficult to measure “energy,” a physician’s willingness to recommend a career in health care is as good a metric as any. According to the physician survey, only 11% of physicians nationally would recommend a career in health care. In Michigan, that number is 53%. That’s huge.
We still have a lot more work to do before we can say that this long slog has resulted in substantial, measurable improvements in the overall quality of care, and overall reductions in per capita health care spending. But, at least we have solid indicators that hearts and minds are optimistic and energized among those who will drive those improvements.