Where Patients Take Precedence
It might seem like a paradox, but Dr. Karl Koenig and his team of 20 clinicians and other care providers at UT Health Austin’s Musculoskeletal Institute have been developing a clinical practice that deliberately puts and keeps patients at the center of literally everything they do.
From when patients enter the building and are greeted by a team of concierge staff, to the hallway motifs that identify locations, to eye-level monitors and examination tables that double as height-adjustable chairs, the two-year-old institute has placed a premium on the patient experience.
“One of the huge advances here at Dell Medical School is that we’re getting to start from scratch,” said Dr. Koenig, Medical Director of the Musculoskeletal Institute and orthopedic surgeon. “We have been able to explore new ideas, go back to the drawing board and take the things that we didn’t think were working well in the traditional health care system and start without them.”
In addition to orthopedic surgeons, Dr. Koenig and his team of experts include physiatrists, physical therapists, chiropractors, nurse practitioners, dietitians, and social workers. Their care plans for musculoskeletal disorders, injuries and pain involve surgical and nonsurgical interventions, such as lifestyle changes, physical therapy and medication.
“We design the way a condition should be cared for based on the best evidence, medical literature and experience from clinical practice,” said Dr. Koenig, “and in doing so, we let the low-value interventions fall away and invest in the things that bring higher value to patients.”
The institute is structured to have six integrated practice units, multidisciplinary teams that are designed around the care of a particular musculoskeletal condition, most notably chronic conditions of the arms, legs, back and neck. In addition, the institute has teams that focus on the care of specialized populations such as athletes for sports injuries and patients with fractures and high-risk foot issues.
“Even that approach is a patient-centered concept, how do we help patients find their way to the right team,” said Dr. Koenig, noting that each care team is led by a specialist supported by associate providers such as nurse practitioners and physician assistants, physical therapists and social workers. However, the back and neck team is led by a physiatrist (a specialist in physical medicine and rehabilitation), because a very low percentage of patients with back and neck problems actually need surgery.
In addition to nurse practitioners, physician assistants and medical assistant, chiropractors, pharmacists and dieticians have key roles on the teams.
Besides a team-based approach to care, the institute’s physical space was designed for the convenience of patients. Dr. Koenig and colleagues worked with the Design Institute for Health, an innovative collaboration between the Department of Fine Arts and the Dell Medical School at The University of Texas at Austin, to create an environment that puts patients at the center of medical practice, with care rooms that have access to two-way language interpretation services, WiFi access and eye-level monitors for easy viewing of images (X-rays, CT, and MRIs), electronic medical records and other resources.
The institute has also produced a two-minute video in both English and Spanish that introduces patients to the team-based care program and clinical care team providers, giving them an idea of what to expect during their visit.
“We’re providing health care in a way that we believe really helps people to get and stay healthy,” Dr. Koenig said.
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