November 2001 • POST-ASSEMBLY EDITION
Practice 2010 can accelerate change in your office
BY TONI LAPP
Although his main-stage "Practice 2010" lecture at Assembly was subtitled "A Revolution in Office-based Care," it is revitalization -- not revolution -- that is needed, said Charles Kilo, M.D., M.P.H.
At any rate, changes are in the works. Consumers, especially baby boomers and Genera-tion Xers, are just beginning to exert their influence, and they want change, he said. "They are activated, engaged and intolerant to paternalism."
The current system's flaws run deep, to the very core, Kilo said. "We are trained to focus on the individual and not on systems. To change, we must focus on systems."
Practice 2010 was designed to accelerate the change, said Kilo, director of the Idealized Design in Clinical Office Practice program of the Institute for Healthcare Improvement. His lecture was complemented by presentations on implementing specific Practice 2010 concepts such as quality improvement and open-access appointment scheduling (see stories at http://www.aafp.org/fpr/assembly/friday/1.html#2 and http://www.aafp.org/fpr/assembly/friday/1.html#3).
The idea is that by the year 2010, family practice will look very different from the way it looks today. But given what's known now, family physicians don't have to wait, Kilo said.
"Health care today is a jumble of Band-Aids ®, and no one knows what's at the core," he said. He suggested peeling away the Band-Aids to get to the solution.
Patients are frustrated; they wait on hold to set an appointment to see their doctor but are told the doctor is booked for weeks. Physicians are feeling dejected and overly managed by managed care. And clinical outcomes are worse than they should be.
With satisfaction over health care at an all-time low, there's never been more incentive to change, said Kilo.
He advised focusing on relationships and knowledge.
Don't just know your patients by name -- know how to pronounce their names, he said, showing an electronic record with the phonetic pronunciation of a patient's name.
When it comes to knowledge, learn to manage the vast amounts of it. Too often, standards of care aren't used, he said. Treatment for conditions as simple as sore throats vary from practice to practice.
He urged participants to evaluate their own methods of applying knowledge, admonishing that "collecting data and managing knowledge are two different things." In his practice, he has organized a chronic disease registry so he can identify his patients according to their conditions. This way, he can follow their progress and evaluate his treatment methods.
Go to the Practice 2010 Web site, http://www.aafp.org/quality/, and click on "Practice 2010 Project" for new resources, such as materials on practice measurement and using e-mail with patients.
FP Report is published by the AAFP News Department.
Copyright © 2001 by American Academy of Family Physicians.
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