First of all, how are you and your family doing in these COVID-19 times?
Chris Gallagher: Like everyone, we are adjusting to a new reality. Kids are remote schooling, and we are taking all necessary precautions to protect ourselves and others from the virus.
However, as the CEO of a telemedicine company with physicians located all over the country, my colleagues and I have the advantage of being accustomed to remote work and have honed skills and techniques to replicate an in-person meeting, discussion, or connection as much as possible. The “work from home” or “work from anywhere” revolution that COVID-19 has spurred in white-collar businesses didn’t impact us as much because it’s what we’ve been doing for nearly 10 years professionally to bring our physician expertise to hospitals all over the country.
Tell us about you, your career, how you founded Access Physicians
Chris Gallagher: I co-founded Access Physicians nearly a decade ago with like-minded physician colleagues who wanted to do more to bring highly skilled, highly trained specialists and subspecialists into more hospitals. We started with the premise that zip code need not dictate physician availability and patient access. I did my internal medicine residency and cardiology fellowship at a large, urban, tertiary health care system and then served as a chief medical officer at a small, rural hospital. Having worked in both settings, the disparity in resources was striking. It didn’t seem right or necessary that a smaller hospital should have to transfer its patients with complex care needs to other, more distant hospitals and away from their friends, families, and support networks when we could leverage technology to bring the specialist to the patient.
How does Access Physicians innovate?
Chris Gallagher: We innovate by focusing on the problems hospitals need to solve to increase access to care for their patients and communities while also promoting financial stability and resilience. For example, one of our early clients needed cardiologists because it had tried unsuccessfully for years to recruit an in-person cardiologist and was losing patients (and revenue) to other facilities as a result. At the time, cardiology wasn’t one of our core service lines. Still, we took the position that we could work with the hospital on a solution that worked for them using our telemedicine model and philosophy as the foundation. Today, that program is hugely successful for the hospital. It showed us that we could adapt, evolve, and innovate by staying focused on partnering with hospitals to craft and implement solutions that address their particular physician and access challenges.
How the coronavirus pandemic affects your business, and how are you coping?
Chris Gallagher: With the COVID-19 outbreak in March and its spread throughout 2020, Access Physicians remained committed to its mission of increasing access to high quality, high acuity, and inpatient specialty care for hospitalized patients. For example, as the need for pulmonary and critical care specialists grew with the number of seriously ill patients hospitalized with COVID-19, Access Physicians created a cohort of rural Texas hospitals to collaborate in the delivery of tele-ICU care. Six rural hospitals in south and east Texas participate, and with the partnership, they can deliver tele-ICU care for seriously ill COVID-19 patients so they can stay in their local hospital and not have to be transferred to a remote, urban facility.
These are hospitals that, prior to the partnership, did not have on-site ICU care because the cost was prohibitive, and recruitment of pulmonary and critical care specialists was out of reach. Through the partnership, board-certified pulmonary and critical care specialists from Access Physicians are available 24/7 for the participating hospitals should they have patients with COVID-19 requiring an ICU level of care, such as the need for mechanical ventilation. Access Physicians worked with the clinical and operational teams at each hospital to ensure on-site resources are available and capable of supporting such a high level of care. In this cohort, telemedicine is a shared resource that enables rural hospitals to maximize scarce financial resources and meet their communities’ needs.
With COVID-19 pushing telemedicine into the forefront, the Access Physicians team went from being part of a small, niche health care delivery system to being part of the national solution…and in some cases, all of the solutions. Telemedicine and direct-to-consumer telehealth have been let out of the bottle with COVID-19, and interest in what we do grew meteorically over the spring and summer. We had already been growing year over year in every metric, from the number of hospital partners and programs to physicians and revenue. To achieve those things has always required our team to be tenacious, committed, and resilient. This year, however, our team stretched and exceeded all expectations so that we could meet the intense and sudden demand for our telemedicine services. Every team member went above and beyond so that hospitals could provide exceptional care, including critical ICU-level care, for their patients. In a single quarter, we grew 20 percent. Our physicians work 5,000 12-hour shifts per month. To do that requires our support teams also to put in long days (and nights). No one has missed a shift. Our level of service and responsiveness has stayed consistent. Despite personal stresses, remote work, family obligations and challenges, and societal upheaval, our team endured and has shown tremendous resilience, adaptability, commitment, and problem-solving skill.
How do you deal with stress and anxiety, how do you project yourself and Access Physicians in the future?
Chris Gallagher: Since our company’s inception, our core values have included kindness. Kindness was a founding principle. With the stresses and challenges, COVID-19 creates – both personal and professional – that value and our commitment to it were tested. We experienced unprecedented demand for our services beginning in March, and our team had to respond quickly and professionally every time.
Maintaining kindness and its partner values of respect and patience wasn’t always easy. It goes without saying that this is an incredibly challenging time for everyone, and those challenges for hospitals and their clinicians on the frontlines are exponentially difficult. They are under extreme stress and experiencing circumstances that most people cannot imagine.
Our patients, too, were experiencing anxiety and vulnerability at new levels. While being in the hospital is never easy for patients, amid COVID-19, most were isolated from family and support systems. Patients in COVID units often were also physically isolated from hospital staff. Our physicians, even though they were “remote” and provided care over a computer screen, were frequently the only face-to-face contact patients had. Without exception, every patient encounter needed to be one of kindness, compassion, respect, and patience.
In response, as an organization, we needed to double down on our commitment to our values. We needed to demonstrate even more patience, compassion, and understanding and empathy for our clients and our co-workers. So while we didn’t initiate this commitment to kindness during the pandemic, we certainly redoubled our commitment to it and made more explicit the need to demand excellence of ourselves in all aspects of our professional interactions with each other, our hospital partners, and our patients. Part of that redoubled commitment means holding each other accountable and being willing to have frank conversations when we weren’t as kind as we should be.
Who are your competitors? And how do you plan to stay in the game?
Chris Gallagher: As a physician-led telemedicine company, Access Physicians stands out from its competitors in its approach to health care. Other telemedicine companies traditionally lead with technology. For more than a decade, Access Physicians has led with medicine and clinical excellence. Our mission is to increase access to high quality, high-acuity specialty care using technology. Other companies seek to increase access to remote technology. In the Access Physician philosophy, health care is paramount, and technology is in the service of providing the best health care.
Second, Access Physicians views every relationship with a hospital as a partnership. Access Physicians partners and collaborates with hospitals, rather than simply contracting with them, to augment the health care services offered and the scope and quality of care delivered. Every telemedicine partnership Access Physicians enters into with a hospital is designed and implemented around each hospital’s goals, protocols, and practices. The company is accountable for those. Access Physicians also works to make telemedicine an easier lift for cash-strapped hospitals. For telemedicine to be within reach of only the largest health systems runs counter to its very promise and utility – increasing access to care in underserved areas and for underserved populations. Access Physicians work with every partner hospital to make telemedicine programs financially feasible to implement and, more importantly, to sustain.
Third, every physician who works on behalf of Access Physicians has thorough training in the art and science of telemedicine. Access Physicians recognize that just delivering care remotely is insufficient. Telemedicine physicians need to practice and hone certain behaviors and characteristics to “break through the screen,” and the patient and on-site clinicians feel their presence and engagement in the clinical consultation. Access Physicians’ “break through the screen” curriculum teaches physicians the importance of connecting emotionally and personally with patients, their families and caregivers, and other health professionals. It teaches how to minimize the physical barriers to interpersonal connection and maximize the integrity and effectiveness of the patient-physician relationship.
We plan to stay in the game by doubling down on these core value propositions. They have served us well for nearly a decade, and they have served us well as we experienced dramatic growth during COVID-19.
Your final thoughts?
Chris Gallagher: We’ve deployed more than 240 telemedicine stroke, cardiac arrest, critical care, and other specialty care programs in hospitals of all sizes and delivered care to 1.7 million patients in nearly 10 years. Through telemedicine, we have put highly-trained specialists – cardiologists, pulmonary and critical care specialists, maternal-fetal medicine specialists, neurologists, and hospitalists – in hospitals that didn’t previously have them or didn’t have enough of them to meet patients’ needs. We have increased access to specialty care, reduced wait times and transfers to other, more distant hospitals, and improved patient outcomes. We’ve done this by staying true to our mission and values.
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