Total Panel Ownership and the Panel Support Tool— <i>“It's All About the Relationship”</i>

Abstract

Frank Brennan, MD, a primary care physician, arrives at work at 7:00 am, to get a head start on the day. It's a Monday and he knows his schedule will be full of patients wanting his care and attention. He enjoys being with his patients, but always needs more time. He diligently works through his schedule, focusing on one patient at a time. Dr Brennan worries about all the patients on his panel who need to come in but haven't. He would like to get back to why he became a physician in the first place: to be with, talk to, and care for his patients in a personal way. But by the end of the day he is exhausted trying to stay on schedule. It's only Monday. Simply running faster will not work. Dr Brennan thinks there's got to be a better way. Rob Unitan, MD, a pulmonologist from the NW Region, Samir Patel, MD, a family practitioner, and Gerard Livaudais, MD, an internist, both from the Hawaii Region, wondered about that “better way” and developed bold visions of how a new approach would work. Through a chance meeting in 2005 at the Institute for Healthcare Improvement (IHI) Summit on Clinic Redesign in Washington, DC, they discovered their common interests. Dr Unitan, Dr Patel, and Dr Livaudais created a new program to dramatically change the way they work that changed forever how they view “care delivery.” “Our work is not the schedule” Dr Livaudais quoted Doug Eby, MD, whom he met at the Washington, DC, conference. “The work should really be our panel, not just those who come in sick.”1,2 Dr Livaudais knew that seeing one patient at a time didn't work and that incremental refinement of our existing system would not get us there. “What we need,” Dr Livaudais continued, “is to totally rethink our methods of delivering care. We should redesign our system with a forward-looking concept that anticipates what we need to succeed to improve the health of the entire population we serve.” What resulted was Total Panel Ownership and an easy-to-use Web-based member database called the Panel Support Tool. —Tom Janisse, Editor-In-Chief