Just What the Patient Ordered

Dr. Steven Matous puts his scrubs on and exacts his surgical skills as thoughtfully as any other health practitioner, but the major difference in his practice lies underneath the surface.

This is because Matous is a general surgeon at Pacific Surgical Specialists, one of eight providers forming the Southwest Medical Group – one of a growing number of physician-governed, multi-specialty practices.

Kurt Litvin, executive director of SMG, said the group's services have been enhanced over the last two years by gauging patient needs. Their care portfolio encompasses seven medical specialties and six surgical specialties spread throughout Vancouver. Altogether, they employ 60 providers – a number expected to rise to about 100 at year's end,  along with two new specialties.

Though the idea itself isn't completely unique, the way SMG's eight providers interact and communicate with each other makes them especially innovative. "This is a clinic without walls, which is attractive to doctors and patients because it's not a closed system," Matous said. "This is the idea that is woven into the whole healthcare reform concept."

Matous explained that SMG provides what people nationwide are asking for from their healthcare system. Ideally, the model SMG is building will be accessible, efficient, responsive and effective in providing community health.

Not only does the multi-specialty bent of SMG provide an umbrella of services for its patients, it also addresses the greater community's health needs. Basically, SMG is able to stay competitive by working together to survey the local healthcare landscape and expand in relation to demand. It makes growth both financially responsible and efficient by minimizing repeat services and balancing the economic feasibility of services.

"Our hospital provides many services annually, regardless of a patient's ability to pay," Litvin said. "Since opening, we've afforded an option for many Medicare, Medicaid and other patients to obtain a provider."

The group's newest location is a perfect example of this orchestrated expansion and continuity at work. Litvin said they established a primary care clinic on Main Street in Battle Ground in response to patients' preference to have a facility close to home that provided the same services as other satellite clinics. Prior to the construction, patients in this area were driving nearly 30 minutes to access care.

Another innovation promulgated by SMC is the coordination and facilitation of patient medical records between different specialties, with a separate IT division handling interoffice communications. "Even in the office you can really hone it down to get some economy of care without changing care at all – less redundancy, more efficiency," Matous said.

Unfortunately, this kind of cost-saving communication between doctors isn't the case nationally.

In 2005, then-President George W. Bush enacted a push to transfer the nation's medical records to a digitized format for storing and sharing information. Unfortunately, mandates regarding compatibility between differing electronic systems were lacking. According to a recent article produced by the Harvard School of Public Health, the presence of hundreds of vendors and systems has created confusion and barriers to accessibility.

Another drawback to the confusion is the lack of obligation or incentive for doctors to refer with each other about patient care. "We've always had alignment of our goals, but when you're separated physically with different medical records it's harder to communicate and you get some inefficiency," Matous said.

That's why SMC's integrated model seems to be enjoying success in keeping costs down on one hand – and keeping patients happy, on the other. "If we share a lot of feedback on our services, then hopefully we'll be able to respond and give the best patient care," Matous said.

Feedback from patients is a strong tool in the medical field, according to Matous, who attributes the recent push for healthcare reform to patients unsatisfied because they can't afford care, don't have access to care, or dislike the care they currently receive. "The more closely your providers work together often translates to how efficiently and timely your care is provided," Litvin said. "It also builds trust, which definitely drives patient loyalty."

These issues and more are acknowledged in the model SMG has adopted and will certainly drive whatever healthcare reform is ultimately passed through Congress.

"If we can fix [healthcare], then we could have a really nice situation," Matous said. "I think the better the experience patients have in a healthcare delivery system, the more likely [patients] are to support it – both spiritually and physically."