Wing of Zock interviews Clese Erikson about hotspots and physician workforce issues

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Salopek: My name is Jennifer Salopek. I'm Managing Editor of the Wing of Zock blog and I'm talking today with Clese Erikson, the Director of the Center for Workforce Studies at the AAMC. Clese, what does the Hotspotting Initiative entail?

Clese: This initiative is a guide for medical students who want to get started with Hotspotting, which is a way to identify super-utilizers of care and think about the social determinants of health that influence their care needs and lead them to go in and out of the hospital and emergency room when perhaps better care coordination might prevent them from doing that as frequently.

Salopek: Why are medical students a good avenue to finding those patients and identifying them?

Erikson: Because they have a lot of energy and enthusiasm and this actually matches with what they're coming to medical school to do. It's a way for them to really identify patients who really need better access to care and better quality of care. It taps into all their idealism and allows them to really dig into the patient's whole history, not just their medical history but all of their life history and all the circumstances that surround them, and maybe help them to understand what it's like to have to travel to a doctor's office when you haven't got money for bus fare, or what it's like to take time off from work when you really are struggling to make ends meet anyway, or what it's like to be a patient in the hospital and be worried about your family at home and who's going to care for you, or to not really understand what the prescription was that was given to you, or to hear the doctor say that you need this prescription but you know full well you're never going to be able to pay for it.

Salopek: Once a medical student identifies a super-utilizer, what do they do next?

Erikson: They approach the patient to see if they would mind being interviewed by the medical student, and the medical student really is there to learn less about their specific medical history about why they are in the hospital this particular time, but more to really understand who that person is and all of the factors; what their housing situation is like, what their family situation is like, to get an understanding of their health literacy and how that impacts their access to care and their utilization patterns.

Salopek: What do you hope students will do with the information they learn through these interviews?

Erikson: We want them to really think about how the healthcare system serves these patients now and how it could serve them better in the future, and to really take this one patient as an entry point into understanding the challenges that face our most disadvantage patient populations.