Do huddles really help in primary care?

By | January 26, 2019

I’ve huddled since before we used the word for it: You want to be prepared for the patients coming in that day. “Followup MRI” – did they have it and what did it show? “Ankle pain” – do we have X-ray today? “Eye pain” – be sure to check her acuity and put her in a windowless room, and did the new fluorescein strips come in? All fast-paced, to the point and here-and-now items.

I’m no sports fan, but I think I know that when sports teams have a brief huddle on the playing field, they speak rapid-fire about the most necessary aspects of play that will help them advance in the game.

I don’t think sports teams huddle about new colors on team uniforms or need for extra practice on how to dribble. So why should medical teams?

But in health care these days, quality jocks and others are trying to also fit health maintenance issues into our fast-paced huddles. Does the woman with acute grief need a Pap smear? Is the man with high fever and splitting headaches overdue for his colonoscopy? Is the diabetic with an appointment for chest pains due for tetanus and pneumonia shots, eye and foot exams?

I’m sorry, but we’ve only got fifteen minutes. People come in for a reason and expect us to handle that issue. The unsolicited, often time-insensitive health maintenance agenda items are ill-suited for the hustle and bustle of primary care visits and their daily huddles.

I have kvetched about this before, but today I have a better argument and a better analogy for how to get the quality work done without slowing down the clinic flow or offending patients any more than we have to:

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There is a different way to do this besides putting more and more on harried provider teams’ shoulders.

Hasn’t anybody in health care ever heard of Constant Contact? MailChimp? Autoresponders? We live in a new era of connectivity, and everybody else is trickling information, tips, and reminders to their customers or communities via email.

My chocolatier sister-in-law doesn’t wait for her customers to drop into her shop or tasting rooms to tell them about her Valentine’s Day or Easter chocolates. She sends automated, season-appropriate emails every so often.

It is time for us in primary care to seriously reconsider how we interact with our patients. It’s no longer all about the brief provider visit. It’s about an ongoing partnership for better health. We can send season specific general reminders via regular emails, and we can post patient-specific reminders on our patient portals. Most of us have hardly begun looking into the potential of this secure form of communication.

Let’s get with the times, automate that which can be automated and make the face-to-face visits count for dealing with the personal stuff.

Hans Duvefelt, also known as “A Country Doctor,” is a family physician who blogs at A Country Doctor Writes:.

Image credit: Shutterstock.com


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