A group of about 30 physicians at Dartmouth-Hitchcock Medical Center has completely revamped the way they deliver pre-natal care to make sure patients don’t feel shuffled from doctor to doctor. The move came in response to a pregnant patient who was not happy with the way her appointments were handled.
Elissa Ozanne started seeing obstetrics and gynecology doctors at Dartmouth Hitchcock midway through her pregnancy, about a year ago. She says she had four appointments with four different doctors and not one of them remembered to order prenatal tests she repeatedly asked for. One day, Dr. Regan Theiler told her it was too late to schedule an important test. That’s when Ozanne blew off some steam.
“You know when you’re a new mom, soon-to-be-new mom and you are trying to do everything for your child and give them every advantage. And you are told you missed a window out lack of communication? It was incredibly frustrating and disappointing,” Ozanne said.
Dr. Theiler remembers that day well, too. She says she had her head buried in her computer, so was taken by surprise when her patient became angry at her.
“And I looked up and she was incredibly unhappy ... and she made it very clear to me that I was not doing a good job,” Theiler admitted.
Some doctors might have become defensive, but Theiler decided Ozanne had a point — that she was being bounced around too many doctors who were not sharing information about her case. So Theiler asked all 30 of her colleagues to reorganize themselves into smaller, color-coded “pod squads.”
“That means that probably you’re going to see three or four, you might see five and you may not be delivered by anyone that’s on your pod. But you have a nurse on the pod that knows your name and you know her name," said Theiler.
Each pod has its own nurse and doctor. The doctor keeps close track of all the patients in it, and meets each week with other doctors who have seen those patients.
“You know that Dr. Theiler or Dr.George knows you are and knows what your major problems are and if there’s something unusual about your ultrasound, [you know] that the members of the pod talked about it at the meeting that week,” Theiler said.
Doctors talking to other doctors about patients they have in common — that may sound like a no-brainer. But in this age of electronic medical records and huge medical practices, Theiler says one-on-one conversations don’t happen as much as they should. The pods, she says, encourage collaboration.
But that doesn’t make it easy for a single pod to accommodate every patient in it. Already busy doctors sometimes have to squeeze extra appointments and meetings into a lunch hour, or at a time normally set aside for paperwork.
“To say there’s not been push back would be a lie. Of course it’s difficult. Change is very difficult,” she said.
But she says her colleagues are committed to making changes that will benefit their patients. And some patients — like Elissa Ozanne — are especially appreciative. That’s because Ozanne herself teaches at the medical school. Her research specialty? Patient-directed care. This year, she was her own best case study. She says she ended up getting the tests she needed from doctors who were both competent and compassionate.
She is now the mother of a healthy 11-month-old daughter.
