Gagandeep Singh, MD; Jill G. Lenhart, MD; Richard A. Helmers, MD; Michele Renee Eberle, MBA; Heather Costley, MSN, RN, CMNL; Joel B. Roberts; Robert S. Kaplan, PhD
Background: Primary care physicians are overburdened with growing complexities and increasing expectations for primary care visits. To meet expectations, primary care physicians must multitask during visits and spend extra hours in the office for charting, billing, and documentation. This impacts the physician’s quality of life and may affect the quality of patient care. Many of the administrative tasks performed by physicians could, alternatively, be performed by nonphysician staff, leading to the adoption of team-based collaborative models.
Methods: Mayo Clinic Health System piloted a team-based collaborative model in a small physician practice in Osseo, Wisconsin, where staff could be trained quickly and efficiently. The model used medical assistants/licensed practical nurses (MA/LPN) to partner with primary care physicians during a patient visit. The LPN/MA, under physician supervision, ordered and monitored pending orders/labs, coordinated patient care, provided after-visit educational needs, and communicated other urgent messages to team members.
Results: After 6 months, a comparison of pre- and post-trial data showed improved staff and patient satisfaction, decreased physician administrative work, and no cost-effectiveness improvement. Screening of medical conditions in the elderly improved, but no change was noted with chronic disease metrics.
Discussion/Conclusions: Data showed improved staff and patient satisfaction, decreased physician clerical burden, increased appointment slots, mixed clinical outcomes, and did not demonstrate cost-effectiveness. The authors recommend that similar models be conducted in large settings to see if these results are reproducible.