Clinical Efficiency and Clinical Coupling

We have to be more efficient.

David L. Bronson, MD, president, Cleveland Clinic Regional Hospitals,  and immediate past president, American College of Physicians

Couples are wholes and not wholes, what agrees disagrees, the concordant is discordant.  From all things one and from one all things.

Heraclitus (c.640-c.480 B.C.), On the Universe

The April 19 issue of HealthLeaders Media features an interview with David Bronson, MD, immediate past president of the 133,000 member American College of Physicians.

Bronson says doctors must become more efficient to handle 30 million more Medicaid  patients, must clarify relationships between generalists and specialists, must inform  people what’s useful and useless, must get rid of worthless tests, and must give the right care at the right time for the right reasons.

True enough, but how?  One small step might be see, treat, and counsel couples at the same visit.  I thought of this yesterday when my wife and I together went to see our primary care physician.  His practice often sees husbands and wives together.

Coupling of couples creates efficiencies.   Husband and wife hear  the same explanations and same advice at the same time.  It sometimes takes two to hear the same truths.  It minimizes  confusion.    Husband and wife can support each other  and remind one another of what was said,  for example, to take a 15 to 20 minute walk three times a week or to comply with the doctor’s prescription or dietary instructions.

How can doctors best increase clinical efficiency?

How can they enhance their practice sufficiency?
One small step might be seeing a couple together.

Bringing them in together in one intimate tether,
That might bolster clinical proficiency.
And correct the doctor shortage deficiency.


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