Panel Management

They say, and “they” are some study I never read but heard about from Dr. DDX, so that’s pretty much as good as gospel, that it takes 14 hours a day to manage chronic disease. As in, 14 hours a day for just your patients with diagnoses like high blood pressure and diabetes, just for panel management. Ensuring they get tests done, follow-up labs, check their blood pressure, learn to eat better, stop smoking, see specialists, etc. etc. etc.  This is called panel management.

14 hours a day for those guys. Not counting prevention of disease in healthy persons. Not counting managing folks who are acutely ill or have an extensive work-up going on.

Not counting, you know, actually seeing patients and the like.

This is how much time it takes to do our patients justice. And how much is allotted providers for this in reality? 35 minutes? Nothing at all?

When I think about this I have a panic attack and 5 more of my hairs turn grey.

Thus I have created a simple, elegant and entirely inadequate Panel Management Device.  I have limited it to the patients whom, when I think about them, I have a panic attack and 5 more of my hairs turn grey. That is my selection criteria. I call it the Shit List.

Now, do not misunderstand me. The patients on this list are wonderful people. The list is not named for them. Nor is it named because they are on my bad side, or because I am angry with them. It is so named because it is the first and only thing I could think of naming it. Also because it is what I might do in my pants if I can’t track these people down for follow-up. Another selection criteria.

No one else knows what it is called. I have labeled it simply S.L. and have drawn attractive and distracting designs on the back side.

Now what I do is occasionally look it over and review outstanding items. I make sure folks got to see specialists. If an imaging study hasn’t been done I have someone remind the patient to do it. Everyone on the list has a follow-up with me in the next month, and a working phone number listed. Hopefully. There’s a revolving list of specialists to curbside, cases to talk through with colleagues, and topics to read about.

Then I have a panic attack and give 17 sticky notes to my MA.

I’m pretty sure this is how panel management works.