In this episode

Professor Elizabeth Woodcock, DrPH, MBA, FACMPE, CPC, founder and executive director of the Patient Access Collaborative (PAC), dives deep into the challenges and solutions surrounding patient access in healthcare. She shares valuable insights on how health systems can break down obstacles and better serve their communities through the power of listening and finding hidden barriers.

“If we don’t listen, the price being paid is by our most vulnerable patients. Their voices are not being heard, they’re fighting to get into our system, they’re getting sicker. We need to be more intentional about finding solutions instead of giving up.”

– Elizabeth Woodcock, DrPH, MBA, FACMPE, CPC

 

Key takeaways

Look for internal, external, and hidden barriers to patient access. 

Many obstacles preventing equitable patient access are created within the healthcare systems, Woodcock said. “I think in health care, we have kind of a black market. We have to know who to call, the right phone numbers. We’ve got the backdoor channels. Many of [the healthcare barriers patients face]  are ones that I would argue we’ve created,” she said. She also discusses external and hidden barriers. Examples of each include:

• Internal barriers, or those created by the healthcare system: Requiring a medical records review, something Woodcock calls “nearly ubiquitous in academic medical centers.”
• External barriers, or those that are traditionally considered as a healthcare barrier: Lack of transportation for the patient.
• Hidden barriers, or barriers that might be difficult to spot within the patient journey: “For example, the fact that we don’t even think about, when we remind patients about their appointments, it’s all in English,” said Woodcock.

“We’ve added this extra layer of complexity that’s really unnecessary,” Woodcock said. These added barriers make access even more difficult for underserved communities.

Listening is key to improving healthcare access.

When asked what health systems with great patient access do differently, Woodcock said: “I know this is a very simple answer, but listen. Really, really, listen.”

She encouraged health systems to go beyond traditional patient satisfaction surveys, which only capture feedback from those who successfully navigate existing barriers. And looking only at metrics like no-shows, Woodcock said, don’t give the full picture. “Think about what a no-show means to the family who doesn’t have transportation two hours away, who doesn’t have the money to pay to get into the parking deck. [As a healthcare industry,] we’re turning that around and saying ‘You no-showed, now here’s a $25 fee you have to pay us,'” Woodcock said. “So let’s turn that around and ask that family, ‘How can we accommodate you?’ Mind blown. It’s such a simple, effective way of realizing we’ve got to do better for our patients.”

By proactively listening—through direct outreach in patients’ preferred languages and addressing real-life challenges like transportation—Woodcock argued that healthcare organizations can create meaningful change.

Healthcare capacity management needs innovation.

Unlike industries like airlines that can adjust pricing or add more flights to meet demand, healthcare has a rigid supply of providers and limited flexibility, Woodcock pointed out. “Supply and demand are fundamentally out of balance in the US,” said Woodcock. “We have too many patients for our providers today…and it’s not like a store where if there’s not milk on the shelves today, we can likely get it the next day. We can’t get a new neurologist for eleven years…we have to do the very best we can with that precious [provider] asset we have today.”

Woodcock recommends addressing inefficiencies in scheduling, eliminating outdated processes like faxing medical records, and using digital tools effectively to help maximize provider time and improve access.