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04.21.2020

The Helpers

by Emily Maxson

“When I was a boy and I would see scary things in the news, my mother would say to me, ‘Look for the helpers. You will always find people who are helping.’” - Fred Rogers

It is so easy to despair in these strange times, and yet I feel myself uplifted daily by those around me, figuratively speaking.  

At Aledade, we work closely with more than 550 “helpers” — independent primary care practices across 27 states — to assist their transition to value based care. It has always been a privilege to work with these practices and see their commitment to their patients’ health. And today, despite incongruent advice from national, state and local public health authorities, inadequate or insufficient personal protective equipment, and slashed revenues due to decreased foot traffic, I see a re-doubling of primary care physicians’ commitment and efforts to help their communities - and each other.

Independent primary care physicians are a fierce breed. They have long resisted the pull of hospital and health system employment by honing business instincts alongside their mastery of medicine. The demands of serving their community and making payroll are all consuming, and there has historically been little cause to collaborate meaningfully with other practices next door, who sometimes compete for the same patients. Accountable Care has certainly catalyzed collaboration, as small practices must join forces to amass a population large enough for an ACO. Even in these arrangements, we typically see practices functioning independently, caring as best as they can for their own flock in hopes that the network will bring down costs in aggregate. But we see Aledade practices truly coming together to collaborate and innovate during this public health emergency.   

Aledade’s Kansas ACOs have long been positive outliers with respect to coordination, built on foundations laid by an especially strong state chapter of the American Academy of Family Physicians.

Still, I was floored to learn that three Aledade ACO clinics in Manhattan, KS (Stonecreek Family Physicians, CenterPointe Physicians and Konza Prairie Community Health Center) were the driving forces behind their community’s incredible COVID-19 response. Drs. Matt Floersch, Segen Chase and Ryan Knopp and their clinics will be partnering with other community organizations to leverage local sites to temporarily house patients discharged from the hospital or SNF with COVID-19, provide a safe recovery zone for infected healthcare personnel, staff a respiratory clinic for follow up of positive patients and enable a drive-through swabbing station for all clinics in town. 

Countless others are transcending community and state boundaries to help patients across the country through this public health emergency. Dr. James Zini of Mountain View, AR is spreading his best practices on home visits to physicians in other states. His thoughtful approach to meeting patients where they are has never been more important, and other providers are learning how to use his protocols to help patients stay safe at home. Dr. Jonathan Lilly and his office manager Nancee Barnette in Dunbar, WV and Avance Care in North Carolina have individually crafted impressively thorough evidence based COVID-19 Response Plans, including drive-by visit and triage protocols. These tools have been distributed across the country with their encouragement, increasing the confidence of providers across the nation and proving that no independent physician needs to face down this epidemic alone.  

 

Doctor conducting drive through visit in personal protective equipment
Dunbar's Doctor Lilly suiting up in PPE and conducting a drive-through visit.

 

When Aledade launched a massive telehealth implementation effort to help keep vulnerable elderly patients safe in their homes, practice physicians lined up to assist the effort. Dr. Josh Lowentritt in hard-hit New Orleans and Dr. Ryan Frazine in Kentucky joined Dr. Lilly in a widely subscribed webinar to help more than 100 practices nationally overcome barriers to telehealth to keep patients safe in this new era, experimenting in their own clinics so that others could benefit from their early experiences. 

When Kosciusko Medical Clinic in Mississippi heard that their fellow ACO physicians at Mission Primary Care were in danger of running out of Personal Protective Equipment, they offered Mission boxes of N95 masks to help tide them over until Aledade’s relief shipment arrived.

 

Box of PPE
One of Aledade's shipment boxes of PPE

 

Every day, across localities, across states, I am seeing our doctors come together as a true community, within and beyond their own Accountable Care Organizations, to share tears and anxiety over patients and staff in danger, to collectively problem-solve, to encourage each other to keep going.  

At Aledade, we don’t have to “Look for the helpers.”  They’ve been here all along.

 

Disclaimer: Aledade endeavors to provide the most recent, actionable information pertaining to the quickly evolving state of emergency around COVID-19. Aledade regularly reviews a variety of publicly available health sources and updates its materials accordingly. Because data, regulations, and official pronouncements around COVID-19 change so frequently, however, some information contained herein may become outdated before we get the chance to update it. For the very latest on COVID-19, please continue to use online resources from CDC, WHO, and your state or local public health departments.