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Cooperative efforts: Building a care team

Dr. Kane Maiers, MD, MS-CR, Area Medical Director
MedExpress

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MedExpress, a national leader in urgent care, is committed to delivering high-quality, convenient and affordable walk-in care. With nearly 250 centers in 19 states, MedExpress offers a wide range of urgent care, employer health and basic wellness and prevention services. 

With warm, welcoming centers and a full medical team, patients can receive walk-in treatment for everyday illness and injury, including more advanced offerings such as X-rays, IVs, labs, minor surgery, stitches, and treatment for broken bones, sprains and strains.

Centers are open daily from 8 a.m. to 8 p.m. with no appointments necessary. 

Collaboration between physicians and advanced practice coordinators (APCs) is critical to quality primary care. From 1999 to 2009, physician assistants (PAs) and advanced practice registered nurses (APRNs) increased their presence in doctors’ offices from twenty-five percent to nearly fifty percent.1

Such an increase indicates that a patient care team that draws from diversity of professionals — PAs, nurse practitioners (NPs), and family physicians (FPs) — creates good outcomes for both patient care and fiscal management. In this setting, advance practice clinicians and physicians are motivated to find the best ways to work together. 

Research points to practices that make for positive, productive relationships in the clinic. Policies that empower all providers to work cooperatively and to the top of their licenses encourage the teamwork needed to meet clinic goals and improve quality and safety.2

Interprofessional experiences at MedExpress

The MedExpress experience tracks closely with the Interprofessional Education Collaborative Expert Panel’s findings, which show that as need for health care services increased over the last decade, utilization of APRNs and PAs has doubled.3

This need extends from frontline patient care to the administration that keeps clinics running smoothly.

At MedExpress, doing the job of medical director well means having a regular physical presence in our centers. Being available to support the medical staff, from resolving questions about clinical guidelines to how they can access their electronic paystubs, drives provider satisfaction. 

Providers happy in their workplace give better quality patient care.

Recently, growing demand presented challenges for MedExpress. An increasing number of patients meant a growing number of medical providers. To preserve valuable face time for our medical directors, MedExpress recruited a teammate to help with daily responsibilities.

 

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A new role: Advanced practice coordinator

Courtney Stewart, PA-C, a veteran provider at MedExpress, was a natural fit for advanced practice coordinator (APC). In this new role, Courtney manages the schedule and handles all clinician needs to ensure smooth operations for patients and providers. 

As an experienced PA with established relationships throughout the centers in her area, Courtney had earned the trust of her fellow clinicians. Coordinating providers throughout the 16-clinic coverage area requires a dizzying amount of old-fashioned social networking. 

The APC engages with physicians and advanced practice clinicians as their go-to person for clinical support and information. As a practicing clinician with over a decade of experience working as a PA for MedExpress, Courtney knows the value of providing all her staff clinicians with what they need to give the best patient care. 

 She values this challenging job, stating: “Provider morale and patient care are supported by good staffing. APCs are essential to keeping the clinic staffed.”

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To support the needs of the center, providers lean on one another as workloads ebb and flow. At MedExpress the benefit to patient care that comes from a well-supported clinician team has shown in the positive patient feedback measured by the Net Promoter Score (NPS). 

Since Courtney began her role working with the medical director to enhance provider engagement, the NPS for her coverage area has improved by five points. Maintaining the culture of team practice keeps the clinic on top in terms of quality patient care.

Team-building for better patient care

By building relationships and earning confidence, Courtney has cultivated a superior team environment. When a doctor is sick or dealing with a family emergency, they can tell Courtney and have faith that in their absence their patients will get good care.

This relationship-based leadership comes from reliable presence and fulfillment of promises. It is important to recognize that a specific degree is less important than the capacity to lead and coordinate a team.

Strict hierarchies based on license don’t serve the team dynamics so important to the culture of care at MedExpress. 

APCs work in clinics alongside their physician colleagues, taking turns seeing patients and providing backup and support as needed. Licenses are respected, and work is directed to the top of a provider’s capabilities.

Their strategies of strong relationship-building ensure MedExpress remains a leader in primary care. Satisfied clinicians bring satisfied patients. Working together, the people of MedExpress are taking on challenges and improving care.

 

The views and opinions expressed herein are those of the authors and do not necessarily represent the views of OptumCare®. The views and opinions expressed may change without notice. 

  1. Johnson, J. E. (2013). Working together in the best interest of patients. The Journal of the American Board of Family Medicine, 26(3), 241-243.
  2. Peterson, L. E., Phillips, R. L., Puffer, J. C., Bazemore, A., & Petterson, S. (2013). Most family physicians work routinely with nurse practitioners, physician assistants, or certified nurse midwives. The Journal of the American Board of Family Medicine, 26(3), 244-245.
  3. Ibid