Lessons Learned: Coordinating Physicians and Providers

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Family Caregiver Alliance

Last week, Miguel's father was referred to a physical therapist to help him regain his strength and flexibility after hip surgery.  Miguel added the physical therapist to his growing list of providers who would need to be contacted for additional appointments.  Between making appointments for the primary care doctor, urologist, home care provider, optometrist and now the physical therapist, Miguel was becoming overwhelmed by the never-ending list of things to do in the coordination of his father's care.  He felt more like he was coordinating a full-scale production rather than simply caring for his father.

Family caregivers are often faced with the challenge of coordinating medical care for a loved one while continuing to provide basic care needs such as assistance with bathing, dressing and medication management.  The family caregiver can also be responsible for managing the household finances and housekeeping. Taking on so many responsibilities, can overwhelm the family caregiver which adds an additional layer of stress.

Physicians vs. Providers: Who Does What?

In today’s structure of medical care, there seems to be a specialist for everything, making it sometimes difficult to understand just who is doing what. Typically, physicians will be healthcare providers with a medical degree, such as a primary care physician, or other medical specialists. Other individuals or organizations that provide some type of medically-supportive care without a medical degree are normally referred to as “providers.” Providers may include social workers, dieticians, nursing assistants, home care agencies and more.

The Benefits of Care Coordination:
Coordinating care between physicians and providers ensures not only that your loved one receives  the best possible care, but can also play a major role in reducing the stress of the family caregiver. Care coordination can also help family caregivers develop a care plan that facilitates communication between medical professional and social services providers. This is essential, as a 2009 study ("Primary Care Physicians' Links to Other Physicians Through Medicare Patients: The Scope of Coordination of Care") reported that the typical primary care doctor may need to coordinate care with 229 doctors across 117 different practices. And, as noted by the lead author, these statistics  are on the conservative side; the study focused only on Medicare patients and physicians―not providers. It is likely safe to assume the numbers to be much higher.

Initiating Care Coordination:
In 2011, the initiation of the Medicare Shared Savings Program and The Advance Payment Model laid out incentives for physicians and providers to offer improved care coordination for seniors and their families via shared savings and increased access to information technologies and other care coordination tools.  Family caregivers who are struggling with care coordination can ask their loved ones primary care provider what services and assistance they can offer. If the physician themselves does not have the capacity to provide care coordination that meets your needs, they may be able to provide a referral to a social worker to better assist you.

It is likely that family caregivers will find a wide variation in the availability of care coordination services offered by physicians. However, the initial time spent getting all of your loved one’s providers and physicians on the same page can reduce the stress and burden of keeping all those doctors and care providers in touch over time.

Have you had experience in coordinating care between multiple physicians and providers for your loved one? If so, please leave a comment and share your tips and experiences.

Content Contributed By ClearCare, Inc


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When my mother-in-law required several drs. and at time therapists, I was running out of room on my calender and was ALWAYS making notes at the appts. and then misplacing them. My solution was a 3 ring binder with separators for every dr. ( along with all contact information and their specialty), therapist ( along with contact information, and their therapy specialty), even hospital visits had a section, all drs., nurses, and any other personelle that came into her room would make notes (I would remove the section after all the follow up visits), and a calender, and copy of current medications, and a section for any questions or concerns we wanted addressed at the appt. I would have the dr. or whoever write notes about that visit, medication changes, and any information another dr. or therapist may need. I would take the binder to ALL appts and ER. visits. Everyone was thrilled to be able to see what the others had done, what test had been ordered ( this prevented repeating the same ones), any concerns that may need addressed by another specialist, etc. It also saved my sanity!

It is a great thing when all of your care providers can coordinate in a way that is most beneficial for you. My sister recently had a whole slew of health problems, and with the help of doctors, therapists, dieticians, and more all working together, she was able to make a full recovery. It was vital that they had the ability to work together and accomplish what was best for her! I also work with senior citizens every day, helping them cover the out of pocket gaps brought on by government Medicare. I know that many of my clients are in the same position! Thanks for sharing, you have an excellent blog. Keep up the good work!

Physical therapists (PTs) diagnose and treat people of all ages with medical or other health-related problems that limit their physical ability to move. PTs practice in hospitals, outpatient clinics, rehabilitation centers, nursing homes, private practice, and other settings. ^