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An Interview Regarding The Everett Clinic Surgery Department
Overview
The Everett Clinic offers a comprehensive surgical program with board certified surgeons of the highest caliber performing more than 3,000 surgeries per year - which equates to outstanding, up-to-date surgical skills. In this interview, Dr. Millie addresses surgery, The Everett Clinic, and the importance of patient-doctor communication.
Interview with Dr. Michael P. Millie, MD, The Everett Clinic
INTERVIEWER: You had said something about getting to focus here, rather than being in private practice. You don't even know about insurance, you get to focus on what's right for the patients. How important is that, and explain to us why you get to focus on the patient?
DR. MILLIE: One of the advantages of being in a large multi-specialty group like The Everett Clinic is that we share the expenses as physicians: business department, marketing department and support staff, so that when we sit down with the patient, face-to-face, my only concern is about that patient and why they're there to see me.
If I were to hang my license on a wall, and open up an office by myself as a private practice doctor, I would have only one choice for who's going to manage the business aspect, who's going to do the billing, who's going to relate to the insurance company, who's going to hire and fire the receptionist and the nursing staff.
In this situation, that's all taken care of by our business department. So, when you meet a physician at The Everett Clinic, that physician is sitting down and is primarily concerned about the patient's problem.
INTERVIEWER: Is it important that this is also a physician-owned organization? Does that play a role?
DR. MILLIE: I think it is important that it's a physician-owned clinic, for a couple of reasons. One is that it is our own personal reputation on the line. This is our business, so we intend to do good business, because if we don't, we don't get to keep working here. In addition, I don't want to hire, and be affiliated with inappropriate practitioners, because it reflects on me. This is my business; we all share it together. So, we do our very best to recruit the very best for that reason.
INTERVIEWER: What would you say about the department? Dr. Goodman talked about the appropriate mix in the department. How would you characterize it, as it relates to a benefit to the patient.
DR. MILLIE: I think when you create or build a surgery department, there are a lot of things that are important. The obvious things are choosing well-trained surgeons, surgeons with specialties that are needed in the community. Those are the obvious, important choices that go into the mix.
What I think patients might not realize is that the collegiality of the group is important. How well do we work together? Can we depend on each other to share call and share coverage of our patients? I don't take calls every single night of the year. There are some points when I'm actually out of town with my family, or I actually go to sleep at night, and I'm depending on my partners to provide excellent care for the patients that I've operated on. So, having a collegial relationship with excellent practitioners is the key to this department.
We meet on a regular basis for conferences, ongoing education conferences, we meet for business conferences. We also just talk to each other in the hallways and the office about our patients, so there's an ongoing constant conversation in our department. I like to tell patients that when they come see me for a consultation, almost always they're getting a consultation with ten surgeons, because usually I discuss their case with my partners so that we can provide the best advice in care.
The other thing that I think is unique for our practice, and me, maybe in particular, is a concept of shared decision making, used to be called informed consent.
And I think most of us in our department see surgery not just as an operation but as a process, so we partner with our patients to teach them about their diagnosis, teach them about all particular surgical and non-surgical options. We try to inform them about the pros and cons of each choice, particular risks and benefits and then we partner with them on the decision making process. I think that that's extremely important, because once a decision's made, patients will invariably do better if they've been a partner in the decision making process. And then there's the rare event when there's actually a complication. It's a whole lot easier to deal with that if they were well-informed about it pre-operatively.
INTERVIEWER: You used the word partner. What makes them a partner in this decision-making process?
DR. MILLIE: Well, I think in old-fashioned surgery, the surgeon was kind of paternalistic. The patient would come in with a diagnosis and the surgeon would tell them what they needed to do to cure the problem. And that's what was done.
I think we see surgery and surgical care a little bit differently than old-fashioned surgeons. I can't do surgery on a patient, without a patient. And so, they are clearly a partner in this process with me, and ultimately, nobody can force a patient to do something with their body that they don't want to do. So, ultimately, all I can do is provide them with a wealth of information: all the pros and cons and risks and benefits, and ultimately a patient has to make a decision. I'm there to provide support in that process, and then do the operation once they decide to do it.
INTERVIEWER: Great, is there anything else that you would want to say?
DR. MILLIE: I don't know if it's appropriate for this, but we were talking about pride in the department and how we're collegial, and you could take that one step further. The truth is that we're actually friends. Our department is very much like a family. We spend an awful lot of time together. Surgeons work sometimes 80 to 100 hours a week and so we spend more time together than we do with our own families. So it is a unique place to work and also because of that, it is a unique place to get surgical care.
The Everett Clinic gives back to its community by working on a national level to better our health care, donating over $3.2 million to Snohomish Country non-profits, and many other ways. In 1994, The Everett Clinic staff and physicians established The Everett Clinic Foundation. The goal of the Foundation is to provide ongoing philanthropic support to charitable organizations in Snohomish County.
The Foundation is administered by a Board of Directors who are responsible for the allocation of funds. Each year The Everett Clinic's Operation Outreach program offers Clinic staff and physicians an opportunity to "adopt" a non-profit organization and give back to the community.
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