Central to most health systems' patient access strategies is some version of "the 3 rights" - right care, right place, right time. These three dimensions are patient and health system focused, addressing both clinical and convenience factors that are important to patients, while also speaking to a health system's cost structure. However they don't sufficiently address factors that are important to the provider. "The 5 rights" builds upon the original three, adding “right patient” and “right preparation” in acknowledgement of the provider's integral role in maximizing the clinical appropriateness of a scheduled appointment.
Clinicians, like other professionals, perform better in certain situations more than others. They have spent a great deal of time training in specific clinical fields and honing their expertise on the job. However, they also have diverse personal interests, philosophies, and experiences that contribute to their unique approaches to care. It should therefore be no surprise that, when matched with the right patients, they can excel personally and professionally. The result? Patients will get better care, and providers will have a means to feel the joy of clinical practice.
Below are three reasons why it’s important to consider "right patient" and “right preparation” when searching for the right providers for patients.
Many Providers Focus on Specific Patient Populations: Some clinicians have built their practice around a specific population, say athletes. These providers likely have trained in areas like injury prevention, repair, and rehabilitation, and are generally trying to help their patients get back to their pre-injury level of high physical activity. While these providers could see any adult with something like persistent knee pain, athletes benefit the most from seeing these providers and likewise, these providers are most effective in supporting the goals of this patient population.
Where a Patient is on Their Care Journey Matters for Effective Routing: Have they already been seen by a clinician for their issue? Do they have a confirmed diagnosis? Have they been told they may need surgery? The answers to these questions may deem the patient more or less appropriate for specific providers. Highly sub-specialized surgeons, for example, would prefer to see patients who have a confirmed diagnosis and have been told they may need surgery as part of their treatment plan. These patients are more likely to convert into surgical cases, which are highly remunerative and allow the provider to do what they do best: operate. Conversely, those providers would not add significant value to a visit with a patient who merely self-diagnosed with the help of Dr. Google. These patients would be much earlier in their health care journey and would be better served by seeing a primary care provider for appropriate diagnosis and triaging.
The Right Preparation is a Critical Component of the Right Match: While the attributes of the patient are important when matching them to the right provider, their level of preparation also has a large impact on the utility of their actual visit. Some more obvious examples include having recent imaging available for a consultation to evaluate an injury, or to have properly completed a bowel prep in advance of a colonoscopy. But there are more subtle examples as well, such as having access to the referring provider's recent visit notes to understand the patient's typical baseline function.
Improved Patient Access Starts with Better Patient-Provider Matching
While accounting for the right patient is important in determining who to schedule with, accounting for the right workup and preparation is important in determining when to schedule the appointment and whether additional actions need to be taken prior to that appointment. It is by no means trivial to account for these in addition to the original three rights. But for health systems that are committed to improving patient access for their business, their patients, and their providers, they must find a way to do so.
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