MDNews - Minnesota

their medical careers are the most commonly discussed issues in this setting. If health plans and other payers may exclude physicians from their plans at will, patient choice is severely limited and physicians will eventually be forced into institutionalized practices through economic pressure. Q What new developments in health care excite you most for improving patient care? A: The most exciting development that promises to decrease healthcare costs while increasing efficiency and improving quality of care is the establishment of healthcare teams. The teams have a physician leader surrounded by quality support staff who address the physician's needs and concerns. The support staff provide patient education and contact during followup, act as scribes, conduct prescription review, provide e-transmission/delivery and serve as a point of contact for additional healthcare needs and questions. We use this system in our office, and patients love it. I delegate everything not required of me as a physician, and I personally do everything that requires a physician. I see every patient, perform every examination, determine every diagnosis and develop every treatment plan. With a large staff supporting me on all other tasks, the patient has a quality overall encounter while benefiting from the expertise of a board-certified dermatologist. My philosophy for a successful physicianleader in this system is: 'Do only that which only you, the physician, can do — delegate everything else." Developing similar healthcare teams benefits clinical practice in a number of ways. While teams can be staff- and laborintensive, the work is more rewarding for people entering the healthcare field. It is more efficient on a personnel cost basis, so expenses are actually reduced. Because each patient is seen by a physician with appropriate support staff — whether nurse clinicians, physician assistants, registered nurses or medical assistants — the quality of care is the same. Rather than physicians focusing on routine tasks (which one colleague called 'The Medical Billing Keep-Your-Job-Forever Act'), we should focus on healthcare teams led by physicians who are committed to quality care for every patient. Q How important is it for you to interact with your colleagues? A: Interaction with colleagues is critical to improved care, and I enjoy being an active participant with other physicians. I participate in medical education and have co-authored both a dermatology textbook and a children's book, Little Charles Hits a Home Run!, which is about the importance of sun protection at an early age. It is rewarding to be both a mentor to pre-medical students and a clinical professor of dermatology at the University of Minnesota Medical School. I invite residents and other physicians to visit and perform clinical rotations in my office, and I always accept invitations to speak to my colleagues at local, state and national meetings. Dermatologists must be accessible to colleagues for help. I am always available at 651-209-3617 to any colleague who has a question or challenging case to discuss. If a colleague needs me to see a patient, I will do so whenever they request. If they want me to see the patient that day, I stay late. If they want me to work them in that week, I will. In fact, our practice maintains two emergency medical appointment slots every day for this purpose. Q Are you currently involved in any health care-related initiatives? A: Yes, two projects. I am developing a project that prohibits cellphone texting while cars are running. The technology exists, so let's use it to save thousands of lives. Pledges are admirable, but they just don't work. This is a system where the phone senses the presence of an automobile and disables the texting function. Distracted driving causes 14 deaths per day in the United States. Can you imagine the national outrage if a medication were killing 14 people per day? (See CrutchfieldDermatology.com/safetexting for more information.) Secondly, I am asking that my colleagues not be so quick to vilify e-cigarettes and take a reasoned and considerate look at them. I personally know six patients who have quit smoking using e-cigarettes in the past three months. One was a two- to three-pack-per-day smoker for 40 years! I've never seen anything like it. We prescribe nicotine gum, patches, sprays and systemic medications with a plethora of serious side effects. Why not view e-cigarettes as another nicotine substitution tool in our medical therapeutic toolbox? Q Any last comments? A: It is essential for physicians to realize the value of their staffs and to support and encourage them. I owe tremendous gratitude to my staff for making our practice successful and for providing exceptional care to our patients. I cannot count the times patients have told me my staff is the nicest, most caring and knowledgeable medical staff they have ever encountered. We have worked hard to make our work environment the best it can be for our staff and have been recognized as "One of the Top 100 Best Companies to Work for in Minnesota" by Minnesota Business Magazine. Again, success in medicine is not just being a great physician; it is also having great staff supporting your efforts to provide the best care possible to your patients with everything working together like an accomplished orchestra under one physician-conductor. ■ MdNewS.CoM ■ MD News Twin Cities | 15

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