Protocols, referral control are key cost measures
New physicians are shadows’ for a week
A new doctor joining Alton (IL) MultiSpecialists can expect to spend a week shadowing another physician to learn about how the practice operates. The training program helps the new group member understand the practice’s procedures, philosophies, and methods of reducing costs, says Virginia L. Drone, CEO.
Here are some of the other programs that Alton MultiSpecialists has instituted to increase efficiency, provide better patient care, and keep costs under control:
Disease management
The practice makes extensive use of protocols as part of its disease management program. In addition, the disease management coordinator, a registered nurse, works with patients with chronic conditions such as low back pain, congestive heart failure, and diabetes. As a result of the patient education programs, for example, the practice has seen a great deal of reduction in emergency room visits for congestive heart failure patients, she says.
Referral guidelines
The practice has worked with its primary care physicians to develop referral guidelines for various subspecialties. The referral guidelines establish what primary care physicians should do to work up a patient or what specifications should be met before the patient is referred to a specialist.
"We have found that from this activity, we have significantly altered referral patterns so specialists are truly getting patients who are ready for care, rather than premature referrals," Drone says.
For instance, the referral guidelines for ear tubes for young children specify that a child with ear infections isn’t referred to a specialist until there is a clear demonstration of chronic disease. These guidelines follow the recommendations of the American Academy of Otolaryngology, she adds.
Referral tracking
All physicians in the practice get together for lunch on Fridays to discuss the appropriateness of referrals to specialists outside and inside the medical group. The group generally looks at 50 to 75 pending referrals at each weekly meeting.
"It is a type of prospective peer review. It helps ensure that referrals from the primary care doctors to specialists are necessary," Drone says. The weekly meetings have cut down on the number of referrals to specialists and have helped the physicians learn from each other, she adds.
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