Capabilities Pt. 1: How Frameworks Free & Empower Physicians

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As the saying goes, “Failing to plan is planning to fail.” But in the complex world of medicine, it can feel like proper planning requires a plan itself and failure is a matter of health and wellness, both patients’ and your own. Burnout is the subject of much scrutiny in the healthcare world. It is painful and costly, it affects providers and patients alike. While there is an abundance of studies and op-eds pointing out the various causes there are far fewer proposed solutions. Where solutions have been proposed, they are typically band-aids, temporary fixes that don’t treat the problem, only the symptom.
Burnout is not unique to the healthcare industry. Therefore, it stands to reason that methods to avoid and reverse burnout in other professions can help in medicine as well.
The concept of “capabilities” originated in the business world; with some variations, this concept also offers a cross-cutting, big-picture solution to burnout in the medical world. We’ll explore this concept in a two-part blog series, starting here with a definition of capabilities and three kinds of organizational support. In part two we’ll discuss how you can leverage the concept of capabilities to help reduce burnout, improve practice operations, and have a happier staff!

What Are Capabilities?

The concept of capabilities originated in the 1990s when Harvard Business School professor Len Schlesinger analyzed the relationship between profitability, customer loyalty, and employee satisfaction across various industries. His research yielded an interesting conclusion: engagement is more important than satisfaction. To increase engagement, employers respect employees’ capabilities.
But what are “capabilities”?
Capabilities are a mixture of skills and support that are fueled by meaning. To phrase it differently, capabilities are a mixture of the what, how, and why of medicine. Providers have a highly specialized set of talents and knowledge, but they need administrative help to make sure these abilities aren’t squandered on clerical work or excessive hours behind the keyboard logging CPT codes. When providers can operate at the peak of their training and experience because support shoulders other tasks, the result is greater workplace fulfillment, engagement, and enthusiasm.
Capability measures the degree to which physicians feel they can provide the best possible care to their patients without obstruction or bottlenecking. Healthcare practices can reduce burnout by establishing a culture that makes considering capability a priority and purposefully designing a working environment in which physicians can thrive.

Three Elements of a Capabilities Framework

The capability model is designed to organize your practice and act as a fallback, a “square one” to return to and consult when making decisions. This model’s built-in simplicity helps to counter the demands, stress, and pressure of operating a small business in the highly technical medical field. The capabilities model is structured around three kinds of organizational support: tools, resources, and latitude.

  • Tools: Any artist knows, mastery of technique and materials comes before vision. Similarly, doctors need the tools to use their vast knowledge to benefit patients. For example, electronic health records (EHRs) consolidate, streamline, and draw connections between data points that tell your patients’ full medical story. They extend the capacity of the physician (since it would be superhuman to be able to remember all of that information), and thereby increase the physician’s capabilities. Another tool is a patient portal system. This helpful mechanism increases communication through secure messaging, sharing test results, and other features. This extends the physician’s reach outside the office, into the patient’s home or workplace, and helps to solidify and strengthen patient-doctor relationship.
  • Resources: There are many resources at a doctor’s disposal, perhaps too many, all of which promise to save time and effort. These “silver bullets” often don’t live up to their promise, and become another cost, distraction, and burden. However, services that aid in billing or revenue cycle management can tighten up finances to help practices collect what they’re owed. Other popular resources include online reputation management (ORM) software that collects online impressions, called “sentiments,” to assess and improve your practice’s digital presence. As for human resources, front office staff and office managers are essential as they coordinate scheduling to reduce no-shows, manage appointments for chronic conditions, and organize population health initiatives.
  • Latitude: “The tighter we get our physicians back directly with their patients, that relationship becomes not transactional but therapeutic — and it cuts both ways,“ says Jim Sams, MD, CEO of Privia Medical Group. Latitude is the freedom for the provider to exercise their refined expertise and best judgment, not only when counseling patients, but also in the operations of their practice. With the proper tools and resources in place, latitude provides the ability to put them into action.

Those are the raw materials of a capability framework. So what comes next?
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