Evaluating Care Models at Top Hospitals to Fit an Individual Patient

Thank you for the thorough reply JK. I hope you continue to get the best care and stay healthy.

2 Harvard / MGH professors each independentely recommended the Mayo Clinic, due to their Collaborative “MICT” approach. However, I still don’t really understand why MICT is unique to Mayo given it would seem to make sense that every hospital would follow such an approach. In any event, the earliest I could get in to see my local (Florida) doctor so as to call and make the referral is on November 11.

** What is really giving me major stress is the waiting - as I need to get healthy to work and make money to pay my bills. If you or anyone knows how to speed the process up, please let me know. **

In the interim, for example, I understand Clevelend Clinic has a MICT program modelled after Mayo. Their program, called “National Consultation Service” (NCS) can be googled and looks ideal. However, just this past Friday, they told me it would take 5-7 months to get the appointments (with various specialists) scheduled. 5-7 months !? That sounds crazy to me, as I don’t know who can wait that long for serious illness - and in my case, financially. Meanwhile, I haven’t learned of any MICT program at Johns Hopkins - a hospital that I find to be administratively a mess, though I understand that they have some of the best doctors. So right now, I am hoping on Mayo #1, Cleveland Clinic #2 and Johns Hopkins #3. Interestingly, I don’t know yet whether to really believe the rankings as to the quality of care but in my experience with the administrative staff, of those 3, Mayo Clinic is definitely #1.

Again though any tips on how to speed up the appointment process is appreciated. I just hope I can stay healthy and financially afloat while waiting.

Thanks, Colleen, for inviting me into this discussion, even though I haven't been a Mayo patient.
@mpflood7 - How wise to research this issue ahead of your visit!

I can share my story of care in the large multi-specialty practice I have been with for 45 years now in the Twin Cities, and contrast it with the care provided through an independent ortho practice I also use. Over that time I have dealt with many health issues.

Here is how the group practice collaborates - I have a primary physician, chosen after several earlier docs "moved on" to other practices. She readily acknowledges when a health concern is beyond her expertise and refers me to a specialist. Based on our working relationship, and her knowledge, she "matches" me with the specialist best suited to my problem and whose expertise and approach she respects. At times she has cautioned me that I need to travel across town to get better care as the local specialist is not the best one for me. It is important to me that she continues to study (she was recently certified in Gerontology - nice since I'm now older) because it tells me she is keeping up on the latest in medicine.

The specialists collaborate with my primary, and at times with additional specialists to plan and manage my care. When hospitalized, other than surgeons, the docs may not be in the hospital, and my care is overseen by a hospitalist who is part of the clinic team. He consults as often as necessary with my clinical care team as well as docs in the hospital.

Recently, I have been treated by my primary, pulmonologist, infectious disease doc, pain management doc, bone specialist, opthalmologist and a specially trained physical therapist, all of whom communicate to manage my care. Several of them have also called me personally to respond to questions sent by other team members or through the patient portal.

This same group managed my Mom's very complex medical issues, all the way through compassionate end-of-life care, and communicated with my sister and me through the entire process. My daughter was the case manager in the assisted living facility where Mom lived, and said her clinic was one of few that always responded timely to her when she left messages, and never required multiple calls to get a reply.

In sharp contrast, my ortho docs, whom I have chosen individually for their specialties in specific surgeries, are in a well-respected but not collaborative practice. When I had severe medical issues after hip surgery, the surgeon never responded to repeated pages and calls, and finally the hospitalist from my clinic stepped in and brought in appropriate specialists. When I asked the surgeon why, he said he knew they would "take care of it" - needless to say I never saw him again & filed a complaint. When my hand surgeon left the practice and I asked for referral to another, who would do a very specific procedure, all I got was a list of their hand surgeons. I had to call my hand therapist for a recommendation to the best person.

I hope this (long) description of how multi-specialty integrated care can work helps you in your decision making. If I did not have this practice to rely on, I would be a Mayo patient, and in fact at one point in my lung illness, the docs were considering referring me there.

I wish you good luck as you seek help - dealing with complex medical issues can be daunting. The added pressure of having only a single opportunity to choose a hospital makes it even more difficult. Mayo is truly a place for the best of care - when my daughter was a paramedic, she often met planes in Minneapolis and transported patients from all over the world to Rochester.
Sue