Physician, Specialist Relationship Leads To Better Care For Patients

A new study from Harvard investigates if physician-peer relationships motivate improved specialist care for patients. The results are not surprising.

The study titled Physician-Peer Relationships and Patient Experiences With Specialist Care found patients benefit when their referring physicians have a relationship with the specialist. Data was published two days after the New Year on January 3, in JAMA Internal Medicine.

Patients should not hesitate to visit their primary care physicians. Visits to the doctor slowed in recent years due to the COVID-19 pandemic.

Harvard findings

The study featured 9,920 specialist visits for 8,655 patients. Data for the patients was obtained from 2016 through 2019 by selecting health records for specialist referrals from primary care physicians working at the large academic health system.

Research searched for primary care physicians who had trained with a specialist together at some point and time prior to practicing. According to the study, specialists who have a relationship with a primary care physician are inclined to provide premier care because of the patient’s referral from that physician.

Patients receiving care were substantially more satisfied with a referred specialist who had prior training with the primary care physician. A major discovery from the study was health care professionals are not necessarily motivated by money, but by recognition in their field.

In a discussion from Harvard Medical School, Warren Alpert Foundation Professor of Health Care Policy at Harvard Medical school and a general internist at Brigham and Women’s Hospital, J. Michael McWilliams, says the study showcases the importance of connections in health care.

“During training, we physicians form strong relationships with other physicians, but then we often practice in isolation — this despite the fact that most of us now work in employed groups and use advanced information and communication systems that should make it easier for us to interact,” McWilliams said. “What our study suggests is that physicians’ intrinsic motivation runs deep — it’s there but often undermined by our system. We need to do a better job of tapping into it.

Williams believes more opportunities exist for physicians to improve their performance.

“One is team care in which physicians can observe each other’s decision-making and lead by example. Another is to make physicians more visible to each other when they collaborate on patient care — for example through e-consults, virtual curbside consults, or other back channels that breed familiarity,” McWilliams said.

Although the study shines a positive light, there were some key admitted limitations. Few instances occurred of primary care physicians referring patients to specialists they trained with. Also, the response rate to the patient experience survey was lower than expected.

The value of primary care physicians

Everyone becomes sick, making the availability of a primary care physician important. For most individuals, primary care physicians are their main connection to the healthcare system. The University of Pennsylvania Medicine says a primary care physician is the most important factor in maintaining good health.

Finding the right physician in the U.S. can be difficult, as every provider approves different healthcare coverage. It is important to see which insurance providers an office receives before arriving for care. In a few months, many Americans will need to make insurance adjustments and may be in search of new primary care physicians.

The Families First Coronavirus Response Act (FFCRA) prohibited states from disenrolling Medicaid recipients during the Public Health Emergency (PHE) to ensure continuous coverage throughout the COVID-19 pandemic. The PHE is set to expire on January 15, 2023, unless the order is renewed.

Because of the PHE, states have not been able to remove individuals from Medicaid. Although most Americans still use private forms of health insurance, over 20% of the population is currently on government-funded Medicaid. According to the U.S. Census Bureau, an estimated 8.6 million Americans did not have health insurance in 2020

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