What does the space shuttle Challenger explosion, Anatares rocket explosion and exam rooms have in common? One thing is for certain; the two explosions embedded a cautionary tale of defective O-rings deep into our national psyche. Overlooking a very small component within the total system could result in catastrophic failure.
As someone prone to look for metaphors in just about anything, I wondered if there was some type of O-ring equivalence in the world of medicine. Granted, the exam room may exceed the O-ring to the solid rocket booster ratio terms of actual proportion, but it’s still a very small part of a $2.9 trillion health care system – and one, I think, that offers a perspective on why that system isn’t working well and how it can be improved without waiting for government action.
On its most essential level, the exam room is where the patient-physician bond is forged, a relationship that can never be overemphasized as to the improved quality it imparts to individual and population health. When it’s at its best, the exam room includes more than one person to assure that the physician can remain focused on the patient, not on the EMR. It also offers an indication to the patient that he or she has access to a clinical team to enhance care coordination.
Sequentially, the well running, team care exam room represents a critical component in the Patient Centered Medical Home, which supports a more effective delivery model for primary care medicine, which in turn, forms the foundation of healthcare reform itself. And on the more personal level, the exam room is where we are most likely to gain our greatest sense of satisfaction in practicing medicine, along with the financial remuneration that makes it all possible.
I’m not exactly sure of how directly the O-ring and the exam room correspond in terms of failure potential, but I do know that in many practices some re-design is in order. Most of those practices will need some onsite support to reach the optimal level of efficiency. But however you choose to improve your exam room process, it’s time to start.
You may not feel like you’re changing the U.S. healthcare system right away, but there’s a very good chance that you will change the way you practice medicine while you gain more enjoyment in the process.