Dr. Deborah Kaufman began her medical career as an OB-GYN in the northeast. After several years of practicing OBGYN in NY she decided to decrease her "on call" obligations (being up all night delivering babies!) by pursuing opportunities in a GYN only practice. A hospital in Florida subsequently offered her the opportunity to open her own practice, where she worked with patients who needed gynecological care. One of her patients was an RN who worked at MedSolutions—and still works at eviCore. It was this relationship that first introduced her to the eviCore family, and set her on a path toward eventually becoming a Senior Medical Director at eviCore.
While Dr. Kaufman enjoyed running her own practice, she decided to earn an MBA in healthcare management because she was curious about how the administrative side of healthcare really worked. "To a practicing doctor, utilization management can be kind of mysterious," she says. In the MBA program, she learned about the important role of prior authorization for providers in the healthcare system.
When working with practicing physicians today, Dr. Kaufman seeks to convey the understanding that eviCore, as a prior authorization provider, is a valuable asset to physicians. In addition, her goals are to:
Help physicians navigate the extremely complicated healthcare system.
Help reduce the administrative burdens that can lead to physician burnout.
Work closely with physicians as one "team" to enhance their overall efficiency.
In addition, Dr. Kaufman spends a lot of her time in job-candidate interviews with physicians. She notes that a lot of doctors observe that during their prior authorization reviews, they sometimes find themselves unsure whether one test is better suited than others. They appreciate that eviCore is available to help them determine the most effective and appropriate test for their patients.
Establishing a respectful relationship
What's really important in supporting physicians, says Dr. Kaufman, is to show our humanity, and the way to do so is through r-e-s-p-e-c-t. "The most important aspect in a peer-to-peer discussion is to let physicians know that we've been there and that we're on their side."
Dr. Kaufman encourages her team to:
- Communicate to providers what we do and why we do it.
- Work collaboratively to help ensure that patients receive the most appropriate tests at the appropriate time.
- Openly express that "we're all in this together" and we want to support the physicians' efforts.
Dr. Kaufman encourages eviCore's physicians to personalize their interactions and to acknowledge their peers' education, experience, and time. While keeping the conversation short (under 5 minutes is best, she says), a best practice for a peer-to-peer is to review the guidelines together and discuss the specific evidence to obtain an informed discussion. She also recommends using language that's less aggressive when discussing deferred cases.
"Peer-to-peer is not about being an obstruction," she says, "it's about being a facilitator."
Making efficient use of the provider's time
Jumping on a peer-to-peer call takes physician time away from patients, so Dr. Kaufman guides her team to cut to the chase. Even within a short call, the two physicians can build a good rapport and, when appropriate, they may determine an alternative test or treatment which may be a more appropriate path of care.
Providing high-quality, affordable care
The prevalence of high-deductible health plans today means that many patients have a financial interest in having their doctor order the best test right off the bat. In addition, ordering and getting tests done is not a lot of fun for either the physician or the patient. "No one," says Dr. Kaufman, "wants to go through a whole lot of unnecessary testing if there's an easier option."