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Supporting Our Community

By John J. Reilly, Jr., MD


(May 2018Mental health wellness is a top priority for our care providers and the communities we serve, and there is an increased recognition that we must actively address this issue to maintain and improve health – our own and those who depend on us.

Earlier this year, our School’s Department of Family Medicine was featured in an article in the New England Journal of Medicine as an example of improving the quality of care for patients while also reducing the level of stress on providers.

The department established a team-based model called ambulatory process excellence, or APEX. Under this system, medical assistants gather data, reconcile medications, set the agenda for patient visits, and identify opportunities to increase preventive care.

The medical assistants report to the physician or nurse practitioner and then remain in the room to document the visit with the patient. After the clinician leaves, the medical assistant remains to provide follow-up education.

Corey Lyon, DO, associate professor of family medicine and medical director of the A.F. Williams Family Medicine clinic, described the result: “The chaos in exam rooms before APEX was akin to texting while driving. The greatest advantage now is that the computer no longer stands between me and my patients. This allows for deeper thinking and connection.”

The provider-patient experience is personal, face-to-face. Eyes are not staring at a computer screen. Ears are used to truly listen.

A dilemma of our hyper-connected era is that technology can make us better at what we do—more information is available to us faster than ever—but it can also interfere with the personal connection that any caring profession must forge.

As a society, we must come to grips with this concern.

This spring, the Helen and Arthur E. Johnson Depression Center of the School of Medicine hosted a lecture by Jean M. Twenge, PhD, professor of psychology at San Diego State University, on the impact of smartphones and social media on mental health and suicide risk.

Twenge’s research focuses on how the ubiquity of smartphones is reflected in the lives of young people. Her book, “iGen,” documents a shift in behavior among the current generation of teens compared with previous ones that she attributes in part to an overreliance on socializing through screens rather than in personal contact.

“But the twin rise of the smartphone and social media has caused an earthquake of a magnitude we’ve not seen in a very long time, if ever,” Twenge wrote in an excerpt of her book that was published in The Atlantic last fall. “There is compelling evidence that the devices we’ve placed in young people’s hands are having profound effects on their lives—and making them seriously unhappy.”

She sees a generation with many connections but few deep bonds. Technology itself isn’t bad, but it shouldn’t be used to isolate ourselves from one another, she said.

Our work requires care and attention and we must not let the tools we use get in the way of a better understanding of our students, peers, and patients. We also need to recognize that sharing some tasks can equal improvements for all.

As Lyon explained, “Providers have to be willing to give up a little control to get the support they need so that they can build better connections with patients without technology interfering.”

While it required hiring and training medical assistants, it showed that working together improves the quality of care. Referral rates for mammography and colonoscopy screening improved. Providers reported a sharp decrease in burnout. Appointments for an additional three patients per provider per day could be scheduled.

Our School of Medicine team is showing us a potential way forward.​ 

With warm regards,  

 

 

John J. Reilly, Jr., MD
Richard D. Krugman Endowed Chair
Dean, School of Medicine
Vice Chancellor for Health Affairs
University of Colorado