What I Learned About the New Face of Primary Care

Seeking treatment from the typical primary care physician practice conjures up images of white coats, a sterile environment and outdated magazines sitting on a battered table in the corner. The primary care office is a place to go when you’re sick. The objective is to get in and out as quickly as possible, and usually with a prescription in hand … or is it? As the concepts of wellness and management of population health continue to evolve, some primary care practices are dramatically changing their approaches to care delivery. Iora Health is a pioneer in this new world.

I had the opportunity to spend several hours in Iora Health’s Freelancers Clinic with the staff and co-founders Rushika Fernandopulle and Chris McKown. The meeting was an eye-opening experience into the way people should and want to engage with their primary care physicians. Nestled into a small building in Brooklyn, the practice exclusively serves members with Freelancers’ health insurance coverage. Members are eligible to come to the clinic without copayments as long as they elect the clinic as their primary care practice.

What did I learn from my visit about the new face of primary care?

  • The new face of primary care swaps a reception room wait for a welcome experience. When I walked into the practice I was unsure I was in the right place. The waiting room looked as if it came out of a Crate and Barrel catalogue with welcoming sofas and sunlight streaming through a large window. The traditional magazine pile was replaced with iPads that permitted you to surf the internet while you waited. The traditional glass window separating patients from staff was nowhere to be found. In its place was a small, round table with a laptop and a phone for the receptionist. And that receptionist might be one of several members of the practice who also serve as health coaches. Adjoining the reception area was a room for classes covering topics from anxiety to yoga, which seemed kind of cool, but it was empty and for a moment I thought, maybe this is just for show.
  • Providers practice a patient engagement mantra: listen first, treat second. The practice primarily consists of a Nurse Innovator, Physicians and Health Coaches; there are four coaches for every physician in the practice. Exceptional empathy and listening skills are imperatives for becoming a member of the team. Each morning the team discusses how better to engage their patients in their health. Role playing is used to help team members hone their engagement skills. I never once heard patients referred to based on their disease state. In fact, conditions and illnesses were almost secondary to the overall well-being of the patient.
  • Patient care is as much about planning for well-being as it is treating the illness. Each team member had a full schedule of patients with visits lasting approximately an hour. Team members wore regular clothing. Without an introduction, it was hard to tell the difference between the physician and the other team members, and that’s the idea. Every team member plays an important role and it takes a village to support an individual on her personal health journey. Conversations with patients are focused on their overall well-being. Team members work hard to understand the underlying issue that may be preventing someone from eating right, exercising or adhering to a treatment plan. And the team spends as much time thinking about how to get members who are not using the practice to come in … which is not an approach that that many associate with a fixed fee arrangement.

The practice has a patient advisory board, where the team solicits feedback on what’s working and what the team can do to improve. Patients refer to the clinic as “our practice” demonstrating a level of engagement unknown in most practices. With six practices across the country, the management team acknowledges that they are still very much in a learning mode, but their early results are impressive: high patient satisfaction and lower costs for the employers and sponsors they work with, and of course for the patient – better health and well-being. While we have yet to find a ‘silver bullet’ in healthcare that drives to optimal health and outcomes, as providers and health plans look to engage individuals in their health, the Iora Health model is a good place to look for some answers.

While we have yet to find a ‘silver bullet’ in healthcare that drives to optimal health and outcomes, as providers and health plans look to engage individuals in their health, the Iora Health model is a good place to look for some answers.

As I left the practice, I noticed that the activity room was full of individuals who were participating in a class led by one of the health coaches. I took one more look around to capture what the new face of primary care might look like in the not-too-distant future. I liked what I saw.

Speak loudly, step boldly!

Follow me on Twitter: @bethbierbower

Images courtesy of www.iorahealth.comJuly 23rd, 2014 1:45pm iora health Beth Bierbower primary care