Developing a spine care IPU with different private practice groups
How can we engage different providers in private practice to participate in a spine care IPU.
I am one of the physician leaders for the musculoskeletal health service line in our health system. Our system has 2 hospitals (>1000 beds), urgent care centers and multiple outpatient sites. There is a mix of employed and non-employed physicians in our system. Personally, I work as a private practice physician (PM&R) providing non-operative spine care. The majority of spine care providers in our system (Ortho, Neurosurgery, PM&R, Anesthesia-Pain) are in private practice groups. In my service line role, I have led spine work groups to start to develop spine care pathways. It has been challenging to bring together various providers from different specialties and different groups (who actually may be competitors) to work collaboratively to improve spine care and control cost of care in our community. Some providers voice a willingness to participate, and we have had success with a small work group (12 providers from different specialties) to start to develop spine pathways.
My next goal is to develop a spine care network for our system (A Spine IPU). This would involve providers of disparate specialties, and in different private groups, working together to develop and utilize standardized care pathways, measure outcomes and even monitor cost of care. The goal is not to tell providers how to practice, but rather to learn from each other to provide better care, and to minimize interventions that do not clearly provide value. Getting all (or even most) providers in our community on the same page has been and will continue to be very challenging. This sort of work is seen as a threat to the status quo (which has been very lucrative for many of these providers).
I would love to hear any suggestions on ways to involve these providers who may feel participation in the network is not in their best interest.
There are always those more influential and respected members in any group of providers – it would be useful if at all possible to engage those providers in this initiative and pursue it as a pilot of sorts. It may be difficult if not impossible to convince anyone to completely relinquish their existing model when they have no burning platform and there would be uncertainty about the gains, unless really it can be structured as all upside–access to additional services and supports without impinging on existing practices. Even then a potential change in locale would be a difficult sale, but I wonder if it can get off the ground by providing a part-time or rotational model?