- A network of volunteer physicians is using telehealth to provide consults and mentorship to where it’s needed the most – health clinics serving the underserved.
The volunteers offer their services for free under the MAVEN Project, a Massachusetts-based program that seeks to link healthcare providers in high-stress, low-resource environments, such as federally qualified health centers (FQHCs) and public health clinics, with the resources they need to become better doctors.
“They offer a wealth of knowledge and expertise and decades and decades of clinical experience,” says Lisa Bard Levine, MD, MBA, the organization’s CEO. “What we have are a group of physicians who are truly best in class, and want to share their skills with others.”
Launched in 2014 by Dr. Laurie Green, a Harvard graduate and San Francisco-based obstetrician and gynecologist, the MAVEN (Medical Alumni Volunteer Expert Network) Project was initially designed to give retired and semi-retired doctors an avenue to continue offering their services at their own pace.
“We want to be the organization that doctors go to when they’re retired or retiring, to be able to continue to make a contribution,” she told the San Francisco Chronicle in a February 2018 profile. “We want to marshal this army of retired doctors.”
But with the nation’s dwindling supply of doctors bumping up against a surge of new patients brought into the system by Obamacare, leaving primary care physicians with overwhelming workloads and little opportunity to improve their craft, the program took on added meaning. As a result, the MAVEN Project became a resource for doctors looking to research difficult cases and learn best practices.
And all of this was built on a telemedicine framework.
“With the advent of telehealth technology, the light bulb just went off,” says Levine. “We were able to create a network.”
Levine says the MAVEN Project was developed with three goals in mind: to give primary care physicians serving underserved populations access to education, mentoring and advisory consults. Current services being scaled are peer-to-peer, with no contact between the MAVEN Project physicians and any patients (some legacy programs involve some patient communication).
“We’re here to give these providers support that’s really needed,” she says. “A lot of these primary care providers are newly trained, or working for clinics that struggle to provide necessary support for their physicians. A lot of them are realizing that this is a gray area in healthcare.”
Generally through two 30-minute sessions per month for three months, a MAVEN Project volunteer connects with a PCP (providers and organizations have to meet a strict set of standards to qualify for the project) for one-on-one mentorship. The idea is to answer any questions the PCP may have, offer guidance and help build up the practitioner’s self-esteem – an important function, considering the high rate of stress, burnout and even suicides in the medical community.
“We’re in the relationship business,” says Levine.
Aside from helping rural and remote doctors to hone their skills, the MAVEN Project also serves an important role in helping to improve care for underserved populations.
By their very definition, underserved populations aren’t getting the healthcare they need. Their interactions with FQHCs, public health clinics and small practices are usually few and far between, forcing the doctor to do what he or she can during the in-person visit. Patients with more complex health concerns may be referred to specialists for further treatment, but they likely won’t go that route because they don’t have the time or money for those appointments.
Through a resource like the MAVEN Project, however, these providers can consult with specialists, gain more insight on certain health conditions and use that knowledge to better diagnose and treat their patients, rather than sending them off for an appointment they likely wouldn’t keep.
“We’re in the business of helping to keep the care local for the patient as much as possible,” says Levine, “and to strengthen the referral appropriateness.”
eConsults are one of the fastest-growing and popular uses for telemedicine. The provider-to-provider service gives primary care physicians access to specialists for difficult or tricky cases, usually on an asynchronous telemedicine platform. They can also enable the PCP to coordinate in-person visits between the patient and specialist when needed.
While the telemedicine platform is gaining popularity across the country, it also can be expensive for small and remote clinics and health centers operating on razor-thin margins, particularly at a time when Medicare and Medicaid reimbursement for eConsults is spotty. A service like that offered by the MAVEN Project can offer welcome relief.
Levine says the MAVEN Project gives local practitioners an opportunity to develop a community, and to “keep the care local for the patient,” instead of sending that patient off to another doctor, clinic or hospital somewhere else. It also seeks to build up the practitioner’s knowledge base and skill set, so that he or she is better able to treat patients and know when a specialist consult is really needed.
“The goal is always ensuring continuity of care,” she says.
Active in California, Massachusetts, New York, Florida, Washington and South Dakota, the MAVEN project now boasts a physician volunteer corps in the hundreds, some retired and some just looking to help out when they have the free time. They’re required to work at least four hours per month, either scheduling consults with member clinics or being on call for incoming requests during their volunteer blocks of time.
“There is no shortage of clinics or networks that need us or that wants us,” says Levine. “Our challenge now is to reach all of them as soon as we can.”