HealthManagement, Volume 19 - Issue 2, 2019

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The doctor-patient relationship can be considered a gateway to value-based care. Healthcare organisations that want to implement a value-based care model need to see the patient as their most important long-term asset.

 

What is value-based care?

 

Value-based care refers to a care-delivery model that is based on delivering patient care that provides healthcare value. But how do you define this value? 

 

The Institute for Healthcare Improvement IHIP Triple Aim framework helps shed light on what this value could mean (IHI Triple Aim Initiative). The Triple Aim framework outlines a care delivery approach that pursues three dimensions:

  • Improving the patient experience of care
  • Improving the health of populations
  • Reducing the per capita cost of healthcare

The concept of value-based healthcare is based on the achievement of these key elements: improving patient outcomes, reducing the negative impact of chronic diseases, helping patients live healthier lives and ensuring patient satisfaction by providing value. The term value is mainly derived from measuring health outcomes against the cost of delivering those outcomes (NEJM Catalyst 2017).

 

The doctor-patient relationship

 

The doctor-patient relationship can be defined as the verbal and non-verbal communication between both the doctor and the patient (Sadati et al. 2018). A distorted doctor-patient relationship has the potential to distort the quality of care. An effective clinical communication that is imperative for providing value-based care should have three primary goals:

  • Effective exchange of information
  • Right treatment decisions
  • Good personal relationship

These goals can only be achieved if there is mutual participation and cooperation between the doctor and the patient and an element of guidance on the part of the healthcare provider. Patient satisfaction is very important when measuring value-based care, and a good doctor-patient relationship can play a key role in not only increasing patient satisfaction but also mutual satisfaction where the doctor feels that their treatment approach is right and the patient feels that their expectations from the consultation were met. 

 

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The doctor-patient relationship can thus be considered a gateway to value-based care. Sir William Osler, a famous Canadian physician, once said, "A good physician treats the disease, and a great physician treats the patient who has the disease" (Centor 2007). Without good rapport and good interaction between the two parties, you cannot hope to achieve successful health outcomes. 

 

A major challenge that we face in healthcare today is the consistent increase in healthcare costs without a simultaneous increase in quality of care and patient satisfaction. Value-based care aims to tackle these issues. Hospitals that are committed to implementing the value-based model are now focusing on the delivery of value that accurately reflects the amount of money they have put in to provide healthcare services. The goal is not just to provide treatment but to improve the overall patient experience which would, in effect, translate into improved outcomes, greater value and greater patient satisfaction (Friedeman 2018). 

 

When we talk about patient experience, we mean more personalised interaction between the patient and the doctor, greater transparency throughout the care journey, and improved customer service. By focusing on improving the doctor-patient relationship, healthcare organisations can provide more value, retain patients and create a competitive edge that sets them apart from other service providers. 

 

Ingredients for value-based care success

When you analyse the key elements that can ensure effective implementation of the value-based care model, you will see that most of them are related to patient satisfaction and patient experience. Greater collaboration between patient and doctor means greater connectivity; increased focus on direct care team means greater attention on patients and prioritising their health; greater alignment between major stakeholders means improved health plans, more effective care teams and shared goals and values; active and more informed patients means more successful outcomes and patients and doctors who are more engaged in care. In simple words, successful implementation and application of the value-based care model is possible if we ensure that patients remain the centre of our focus. Value-based care and patient-centred care go hand in hand, and the doctor-patient relationship is at the core of this philosophy. 

 

Value-based care and patient loyalty

A satisfied patient is a loyal patient. A patient with great care experience is a loyal patient. An engaged patient who is allowed to take an active role in their care plan is a loyal patient. In short, patient loyalty can help meet the demands of value-based care. The only way healthcare organisations can ensure patient loyalty is by becoming their trusted partners and their top-of-the-mind contact in case they fall ill. If providers want patient allegiance, they need to build strong relationships with them, and they need to gain their trust (Heath 2018). 

 

Healthcare organisations that aim to succeed at achieving value-based care need to see their patients as their most important long-term asset. If they can provide value and keep their patients healthy, they will continue to demonstrate a healthy performance as well. It is all connected, with the patient at the centre of it all. 

 

Key Points

  • The Triple Aim framework outlines a care delivery approach that pursues three dimensions: improving the patient experience of care; improving the health of populations; and reducing the per capita cost of healthcare. 
  • A distorted doctor-patient relationship has the potential to distort the quality of care.
  • An effective clinical communication that is imperative for providing value-based care should have three primary goals: an effective exchange of information; right treatment decisions; and a good personal relationship.
 
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References:


Centor, RM (2007) To be a great physician, you must understand the whole story. Medscape General Medicine 9(1): 59.

 

Friedeman, J (2018) 3 ways value-based healthcare is improving patient relationships. Available from evariant.com/blog/3-ways-value-based-healthcare-improves-patient-relationships/

 

Heath, S (2018) How patient loyalty supports value-based care, patient wellness. patient satisfaction news. Available from patientengagementhit.com/news/how-patient-loyalty-supports-value-based-care-patient-wellness 

 

IHI triple aim initiative. Institute for Healthcare Improvement. Available from ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx

 

Sadati AK, Tabei SZ, Lankarani KB (2018) A qualitative study on the importance and value of doctor-patient relationship in iran: physicians’ views. Open Access Macedonian Journal of Medical Sciences. doi: 10.3889/oamjms.2018.361

 

What is value-based healthcare? (2017) NEJM Catalyst. Available from nejm.org/what-is-value-based-healthcare/