On The Hot Seat

Doctors need bigger role in health reform

Dr. Gene Lindsey, president and chief executive of Atrius Health, an alliance of five nonprofit community-based physician groups in Eastern Massachusetts. Dr. Gene Lindsey, president and chief executive of Atrius Health, an alliance of five nonprofit community-based physician groups in Eastern Massachusetts. (Jodi Hilton for The Boston Globe)
By Robert Weisman
Globe Staff / July 19, 2009
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Dr. Gene Lindsey, 64, is president and chief executive of Atrius Health, an alliance of five nonprofit community-based physician groups in Eastern Massachusetts, including Harvard Vanguard Medical Associates. He is a former chairman of both Atrius and Harvard Vanguard. Lindsey, a native of South Carolina, received his medical degree from Harvard Medical School, where he is currently an assistant clinical professor of medicine. He joined Harvard Vanguard in 1975 and practiced cardiology and internal medicine at its Kenmore, Wellesley, and West Roxbury practices. He spoke to Globe reporter Robert Weisman at the Atrius office in Newton.

How do you apply your background as a doctor to being CEO?

Well, I don’t think it would help me to be CEO, say, of a steel production company or something like that. But as the CEO of a medical organization, I think it allows me to be more intimate with the people who make up this community in terms of understanding what they really care about. And it also helps me understand the needs of patients from having tried to fulfill them as a practitioner myself.

You e-mail with patients. Why don’t more doctors do that?

That’s complex. I think the answer probably is different for each physician. The generalization is that it’s difficult to answer questions in brief, concise ways in an e-mail. And I think there is a fear that if you open the door to it, you will be inundated by it and that will be the only thing you do.

Our physicians already have very complex daily schedules, and figuring out the rhythm of when to do it and how to do it is difficult for some people. Everyone who has given it a real try has discovered it’s a great benefit, both for them and their patients.

Will this be a bigger part of the patient-doctor relationship going forward?

Absolutely. I think the most important concept that is surprisingly missing from many of our conversations is how do we engage patients. It is a good way to be involved in a productive relationship with your patients. There is an engagement when you have an e-mail exchange. That’s the utility I see in it. It also allows us to be with our patients more than the time when they’re in the office.

How do you see the healthcare reform taking shape in Washington affecting doctors? And what role will doctors play?

I hope we play an enlarged role. I was personally, and at a professional level, challenged and excited by the president’s call for responsibility. And I believe that as a profession we need to increase our commitment to making it work, and that the role of the physician in the healthcare reform has been underplayed. I think we have a lot to offer, and it will require that we’re prepared to change. But so far it has been about how little we need to change rather than about how much we could change.

What are some of the changes that you think are needed?

I think we need to change the way we practice. I think we need to find new ways to engage with patients that are more convenient for them, that are less oriented around our needs and more oriented around their needs. I think that we actually need to be much more cognizant of the resources we use and the way in which we use them. I think we need to be more collaborative, both with our patients and with our colleagues.

What are you doing to address the shortage of primary care physicians?

Within our organization, we’re following two philosophies. One is if there is any doctor to be hired, we want them to give us consideration. So we’re trying to make the professional opportunity that we offer very attractive. We’re also trying to make their jobs easier, and we’ve devoted a lot of our resources to supporting their work. We call it job do-ability.

Finally, we’re trying to look at creative ways where we can bring other healthcare professionals - who actually in some instances have better skills for certain activities than physicians - into the mix. There are a lot of things that doctors are asked to do now that they don’t do well and other people can do well. And the things they do best they’re frequently not given enough time to do. We’re trying to match doctors with what their true skills are, which are problem solving, not filling out forms.