From considering patient lifestyles and non-medical needs to combining multiple services under one roof, find out how the AIDS Healthcare Foundation is transforming patient-centric care from its Chief Medical Officer, Dr. Michael Wohlfeiler.
Patient Centered Care (ft. Dr. Michael Wohlfeiler)
How AHF is innovating patient-centric care
GUEST BIO:
Dr. Michael Wohlfeiler:
Dr. Michael Wohlfeiler is the Chief Medical Officer of the Aids Healthcare Foundation. After spending a short time as an attorney, Wohlfeiler decided to pursue a medical degree and saw firsthand the ravages of the AIDS epidemic during his residency. This inspired him to go into practice treating primarily HIV patients, which ultimately led to his practice being acquired by the AHF. He’s been with the Foundation ever since.
Learn more about Michael:
CORE TOPICS + DETAILS:
[4:08] – A Job That Feels Good Even When You Feel Bad
Let purpose lead your career
Dr. Wohlfeiler speaks on the power of a career somewhere like AHF, which means that even after a bad day, one can always be comforted by the knowledge that they’ve been doing worthwhile and meaningful work. We can’t all work for nonprofit organizations, but we can choose careers that let us pursue something that brings us passion— even on the bad days.
[5:33] – The Power of Patient-Centered Care
Putting the patient first
AHF practices patient-centered care, which is about putting the patient at the center of all healthcare, viewing the healthcare journey through the patient’s eyes, and making their journey as positive and beneficial as possible. It’s about reducing obstacles and barriers that patients may face in accessing care while also considering all aspects of a patient’s life.
[12:28] – Constant Assessment, Continual Evolution
Why healthcare providers can’t stay stagnant
AHF is constantly assessing their approach to healthcare and the models they use throughout the organization. Using select key indicators, including client experience scores, they’re able to track where changes need to be made to processes, strategies, and personnel.
[16:26] – Embracing Holistic Health
Everything patients need under one roof
One way in which the AHF has innovated has been in the bringing together of multiple services— clinics, STD diagnosis centers, treatment centers, pharmacies, and wellness centers— in one location to make the process as convenient as possible for patients and giving them complete care.
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ABOUT AHFTER HOURS:
The AIDS Healthcare Foundation is the world’s largest HIV/AIDS service organization, operating in 45 countries globally. The mission? Providing cutting-edge medicine and advocacy for everyone, regardless of ability to pay.
The AHFter Hours podcast is an official podcast of the AIDS Healthcare Foundation, in which host Lauren Hogan is joined by experts in a range of fields to educate, inform, and inspire listeners on topics that go far beyond medical information to cover leadership, creativity, and success.
Learn more at: https://www.aidshealth.org
ABOUT THE HOST:
Lauren Hogan is the Communications Manager for the AIDS Healthcare Foundation and has been working in a series of roles with the Foundation since 2016. She’s passionate about increasing the public visibility of AIDS, the Foundation's critical work, and how everyday people can help join the fight to make cutting-edge medicine, treatment, and support available for anyone who needs it.
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In Detroit, history was made when Barry Gordy opened Motown Records back in 1960. More than just discovering great talent, Gordy built a systematic approach to launching superstars. His rigorous processes, technology, and development methods were the secret sauce behind legendary acts such as The Supremes, Stevie Wonder, Marvin Gaye, Diana Ross, and Michael Jackson.
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Lauren Hogan:
Get unfiltered lessons from our leaders at AHF as we uncover real, raw stories of where we came from and where we are going. Join us for an unscripted look at the connections our senior leadership have to our mission, core values, and hot initiatives. AHF is the world's largest HIV/AIDS service organization operating in 45 countries globally, 16 states domestically, including DC and Puerto Rico. Our mission is to provide cutting-edge medicine and advocacy regardless of ability to pay.
Lauren Hogan:
Hello and welcome to the After Hours podcast. I'm your host, Lauren Hogan, serving as your liaison to take you through this journey to learn more about AIDS Healthcare Foundation. First up, we're going to get into the topic of AHF Unfiltered. Before we start the show, please make sure to remember to check out the show notes so you can follow along. Now, let's get started.
Lauren Hogan:
Hello, everyone, and welcome to the After Hours podcast. And we have a very special guest with us today, Dr. [Wohlfeiler 00:01:05], or as we would commonly call you, Dr. Wolfie. So welcome to the show.
Dr. Wohlfeiler:
Thank you. Yeah, it's great to be here. Thanks.
Lauren Hogan:
So really quickly, we just want to do a quick guest introduction. So just tell us about yourself and what initially attracted you to join AHF.
Dr. Wohlfeiler:
Well, if we go back a ways, I actually started off my professional life as an attorney, but spent three years doing that and really hated it, and had always had this desire to be a doctor, but hadn't really pursued it because truthfully, science and math were not my strongest points. But I decided to go back and do a year of pre-med and try to get into med school and it all worked out. So I went to med school from '83 to '87 and then came out and started my residency in internal medicine. And that was at a time when HIV was really hitting hard and it was really considered pretty much a terminal disease at that point. And I had chosen to do my residency at University of Miami Jackson Memorial Hospital, which was really one of the epicenters of HIV. And so I started working with HIV patients in my residency and decided that's the patient population I wanted to continue to work with.
Dr. Wohlfeiler:
So I finished my residency and went into practice that was focused primarily on HIV patients and did that in my private practice up until 10 years ago, when AHF approached me and my medical partner, and honestly had not even heard of AHF at that point, but loved their mission and their advocacy. And we decided to let AHF acquire our practice. So that's how I originally came to AHF. And then after a year, they asked me to become the first regional medical director for the Southern Bureau. And then a year after that, they asked me to become the chief medical officer.
Lauren Hogan:
And so how long in total have you been with AHF? How many years?
Dr. Wohlfeiler:
So I've been total with AHF 10 years and 8 years as the chief medical officer.
Lauren Hogan:
So that's quite a long time. So what has made you stay at this organization for so long? And what specifically now do you love? Has it changed from your initial interaction to now? So two questions. What made you stay and has the love of the work that you're doing, has it changed?
Dr. Wohlfeiler:
I stay because I still have a real commitment to the HIV positive population and AHF just does incredible work. One thing I always say about AHF is as with any job, you can have a bad day where come home and you're not particularly happy and you're stressed and so forth. But the difference is that when that job is at AHF, you always feel good about the work that you're doing as part of this organization. I mean, I kind of defy anybody who works at AHF to feel like they're not contributing and making an impact. And that's a really wonderful place to be. And AHF really lives its mission every day. It never loses sight of its mission. And that really drives all the decisions. And I love that as well. And then the other piece is the whole advocacy piece, which of course is not something you can really do much if you're in private practice in a small practice, but an organization like AHF can have such an impact in issues that can people's lives better.
Lauren Hogan:
So actually, I think that's a great segue to my next question. Can you describe for us in detail what is patient-centered care? Like? What does that mean?
Dr. Wohlfeiler:
So, patient-centered care is really what it says. I mean, it's about putting the patient at the center of their healthcare. And it really means essentially viewing the healthcare journey through the patient's eyes and trying to make that journey as positive and as beneficial to the patient as possible. It's about reducing obstacles and barriers that patients may face in accessing care. And it's also about taking into account all aspects of a patient's life. So not just looking at their healthcare, but looking at what we call social determinants of health, like are they having transportation issues that prevent them from getting to the clinic? Are there childcare issues? All of those kinds of things. And it seems kind of really basic that healthcare should be patient-centered, but the truth is that it really hasn't been in many, probably the majority of healthcare settings.
Dr. Wohlfeiler:
I mean, even when I first started in this position as CMO, I was dealing with a number of our own providers who had really lost the idea of being patient-centered, and they were more focused on adjusting schedules so that it would be easier for them, not that it would be more accommodating to patients. And those kinds of concerns that they would bring up were really more about them than it was about the patient. And I think we've done a very good job of changing that attitude. And we've still got ways to go. It's the kind of thing that you have to constantly work on. But I think we've taken so many steps to make our care more patient-centered.
Dr. Wohlfeiler:
And it's not just in terms of the attitudes of the providers or the staff. It's also doing things like when we build a new healthcare center now, we're trying to actually construct it in a way that is puts the patient at the center. We're getting rid of private offices and we're building these work areas in the middle of the clinic with the exam rooms arranged around them so that the patient is always first and foremost and you're always seeing the patient, interacting with the patient. You're not hiding away as a healthcare worker.
Lauren Hogan:
So if you could take what you just said and kind of... I just want to summarize it for our listeners. What are three key components that you would say that are needed in order to ensure a positive patient experience? And this can even be for those too who aren't necessarily in a patient-facing role. What are three components or key components that are needed?
Dr. Wohlfeiler:
So one I would say is access to healthcare. Most sources for healthcare clinics and private offices have been set up as kind of a 9:00 to 5:00, Monday through Friday, which is okay, but it is not always the easiest thing for patients, especially ones who work. So it's about trying to expand access by... And we've done this in a number of places, sometimes having nontraditional hours or even considering Saturday hours. But it's also within the hours that the clinic is open. It's about putting the patient first. If the patient's got a need, we don't want the front desk to say, "Okay, well, we'll give you an appointment in three weeks." It's about saying, "Okay. We'll double book. We'll see this person over lunch, whatever it is, to give the patient access to their healthcare in a way that works for them."
Dr. Wohlfeiler:
So that's one of the basic elements. Another one is that you're taking care of the whole patient. You're not just addressing the pure medical issues, but you're also taking a look at the patient's life, at things like social determinants of health, at stresses that may be impacting the patient's ability to adhere to their medical regimen or is just impacting the patient's quality of life. So it's really a holistic approach as opposed to a very narrow approach to care. And I think the other thing that's really important... and I guess the first two kind of lead into this... we want patients to feel like the clinic staff is extended family. We want our staff to view them and treat them like they would family members, and we want patients to feel embraced by our clinic staff. And that turns out to be incredibly important in keeping patients retained in care.
Dr. Wohlfeiler:
One of our big concerns and one of the big concerns about HIV patients in any setting is that there's too many patients who drop out of care. And we know that when an HIV patient drops out of care, that not only can their disease progress, but they also become a source of new infections once their viral load isn't suppressed anymore. And so keeping them in care is really important. And I think that one of the most important elements to keep patients in care is to make them feel like their healthcare center and their healthcare providers care about them and that they are kind of family. So those are all things that we're trying to achieve in the department of medicine at AHF.
Lauren Hogan:
Absolutely. And so how do you determine, for instance, when changes need to be made to your current models in the healthcare space? So do you guys do an assessment? Do you constantly do weekly calls? What do you do to determine when something needs to be changed to the model?
Dr. Wohlfeiler:
So we are constantly assessing. We've got certain key indicators that we keep a very close eye on, and we look at client experience scores. And if we see any site that is kind of slipping, we immediately intervene. Sometimes we actually end up switching out personnel. I mean, we try to do a very good job of hiring people. And I have to say that we've actually done surveys that have shown that our employees, the vast majority of them really strongly identify with and believe in the mission of AHF. So we've got these really committed employees for the most part.
Dr. Wohlfeiler:
But every once in a while, somebody's not a good fit and they maybe don't treat patients the way that we would like them to be treated. And then if we can't fix that, then we move them out. And in the department of medicine, we're having constant meetings with medical directors, the regional medical directors, the regional leaders. And so we're constantly monitoring for any problems that arise. And then we just try to be very focused on fixing them. I frequently will fly out to a clinic that's having a problem and along with often others from AHF management. And we'll sit there and we'll sit with the staff and we'll try to come up with a fix.
Lauren Hogan:
So what does the future look like in our HCCs? Are they all in one models? Are there no waiting rooms? What do you project or hope for the future in our healthcare centers?
Dr. Wohlfeiler:
Yeah. So that's an area that's undergoing a lot of change right now, which is, I think, really exciting. So our clinics were always pretty much kind of a standard doctor's office kind of set up with the waiting room, and then you get called back, and the exam rooms are past the waiting room and lobby. And we're trying to get rid of a lot of that separation from that design. So as we're building these new clinics, as I mentioned, we're doing a much more open kind of plan and we're putting workstations where the doctors and the clinical staff work instead of having them closed off in offices, and we are putting the exam rooms then around that workstation. So there's much more visibility and much more interaction.
Dr. Wohlfeiler:
We are trying to get rid of waiting rooms as much as possible. And part of the new clinics that we're designing is we're trying to design them with enough exam rooms that as soon as the patient arrives and checks in, they could be taken to the exam room instead of sitting in a waiting room. And we're also bringing the services to the patient in the exam room. So instead of making the patient walk from one place to another within the clinic, we're bringing the services to the patient in the exam room, whether it's doing the vitals in the exam room or drawing the blood in the exam room, or having them meet with somebody in the office who needs to get some information, we're trying to bring that all to the patient. And so that's kind of our concept for our new designs on our healthcare centers.
Dr. Wohlfeiler:
And then the other thing that we're doing is... not every place, but in certain locations, we're bringing mean multiple services, business lines that AHF has together under one roof so that instead of having clinics that are separate from wellness centers, which are our free walk-in STD diagnosis and treatment centers, we're combining all of these things under one roof so that in one building, there's the clinic, there's the pharmacy, there's wellness, there's an out of the closet store, perhaps, our thrift stores, and trying to make everything as convenient to the patient as possible kind of one stop shopping.
Lauren Hogan:
Absolutely. And so one last question for you because we are pretty much at time. So what tools are in place to ensure employees and patients know where we are going and why?
Dr. Wohlfeiler:
So we have a lot of meetings, not just within department of medicine, but we have a lot of what are called joint ops meetings, where department of medicine and meets with say our public health division or our managed care division. And those happen on a very regular basis.
Dr. Wohlfeiler:
We try to create an environment where everybody feels comfortable bringing up concerns, that they don't... We work very hard to make sure that there's no retaliation against anybody who raises concerns about something going on or something that they think should be changed. I think it is always a challenge, though, to... Some people are much better at speaking up than others. And sometimes, unfortunately, you don't find out that there's a problem until it becomes a crisis. But I think we're constantly trying to discover any issues as soon as we can and be able to resolve them before they ever do become a crisis. So I think a lot of it is about the culture and the atmosphere, and that's the work environment atmosphere. And I think that's something that we continue to try to make as open and non-judgmental as possible.
Lauren Hogan:
Well, Dr. Wolfie, I have to say thank you so much for taking the time to come out and participate in the podcast. This was very informative and very helpful, I think, to those who want to possibly join the medical profession at AHF.
Dr. Wohlfeiler:
You're welcome.
Lauren Hogan:
So thank you so much, and amazing episode.
Dr. Wohlfeiler:
Thanks.
Lauren Hogan:
Thank you so much for joining us. If you enjoyed this episode and you'd like to help support the show, please subscribe, share it with your friends, like, post about it on social media, or leave a rating and review. Follow us on Instagram at After Hours and see you next time.