Practice Profile: ENT Associates of Greater Kansas City: Valuing collaboration and communication in patient care

September 2018 – Vol. 37, No. 8

Finding time to talk with Douglas H. Cowan, MD, a practicing otolaryngologist, humanitarian, husband, and father times two with a third on the way, provides a small glimpse into the busy lives of Academy members.

Douglas H. Cowan, MD

Dr. Cowan, like all members who wear multiple hats that span their personal and professional lives, carved time out of his schedule to talk with the Bulletin about the “unique honor” of being the managing partner of ENT Associates of Greater Kansas City.

“Being so busy is a result of me loving what I do,” Dr. Cowan said. “I’ve been fortunate to match my passion for helping others with a career that I love. I was determined to pursue  otolaryngology after interacting with Douglas A. Girod, MD, on a medical mission to Guatemala. He is truly the epitome of a caring physician. Dr. Girod has distinguished himself not only as a great surgeon and academic leader, but also a great person and friend. I’ve been blessed with incredible mentors and colleagues along the way. I owe so much of where I am today to these mentors and the opportunities they have entrusted in me.”

Dr. Cowan started at ENT Associates of Greater Kansas City out of residency in 2012. Joining him during the Bulletin interview were two of his colleagues from the group: Kelvin L. Walls, MD, who has been with the practice for nearly 26 years, and Jason A. Showmaker, MD, who is new to the practice. Dr. Cowan encouraged Drs. Walls and Showmaker to sit in on the interview, which is reflective of the team-oriented and collaborative infrastructure implemented at ENT Associates of Greater Kansas City.

Top row: Andrew S. Pavlovich, MD; Jay Dunfield, MD; Brandon Johnson, MD; John C. Ellis, MD; Kelvin L. Walls, MD; Douglas H. Cowan, MD Bottom row: Blake L. Anderson, MD, PhD; Katherine I. Aberle, MD; Candra Manley, AG-ACNP; Colleen N. Johnson, MD; Daniel A. Sleve, MD Not pictured. Jason A. Showmaker, MD; Stanley W. McClurg, MD; Nicholas Wirtz, MD; Erin Angotti, DNP

The practice has been serving Kansas City for over 50 years. It is the largest ENT private practice in the metropolitan area and one of the largest in the Midwest, currently contracting with five different health systems across 12 locations. The practice includes 16 otolaryngologists, 14 audiologists, and nearly 100 employees.

“We have an amazing culture where we encourage everyone to openly discuss concerns and ways to improve patient care. Our providers collaborate extensively both in person and on continuous, daily chat feeds. It’s common to have multiple providers review a challenging case the same day the patient is seen. In addition, we encourage our physicians to ask for assistance on more intensive surgical cases. This collegial approach is one of the most important ways we improve patient care by learning from each other. We can always get better,” Dr. Cowan said.

Using technology to stay connected and to enhance collaboration, the group started using a communication platform three years ago to enable quick and constant consultation opportunities among their providers. Drs. Cowan, Walls, and Showmaker agree that this model of clinical integration and communication is essential to achieve best practices.

“By developing a model that better supports the physician, it allows the strengths of each provider to develop. Some providers may have a more entrepreneurial spirit, others enjoy finding creative solutions to challenging problems, while others enjoy putting full focus on the daily work of clinic and OR. With the right infrastructure, you can bring out the best in all your physicians. And I can attest that ENT Associates of Greater Kansas City is doing just that—bringing out the best for patient care,” Dr. Showmaker said.

Dr. Walls expanded on that sentiment. “We also extend the model to fit the type of lifestyle our physicians are seeking in their pursuit of work-life balance. We are innovative, embrace new technologies, and provide flexibility so that our physicians and staff feel they are a part of the practice in a way that they define. We strongly believe our culture improves job satisfaction and helps prevent burn-out.”

“The practice of medicine is funny in some regards,” said Dr. Cowan. “Hopefully, you enter the field to give everything you have to help those in need and ultimately better people’s lives. We spend countless hours learning about different diseases, anatomy, surgical techniques, and medical treatments and continually evolve with best practices and new technology. Unfortunately, a successful private practice requires much more than countless hours spent on the clinical aspect of medicine. There is a real business component to a thriving private practice. It’s almost unheard of to learn the business of medicine in training. It almost feels wrong to think about anything but patient care. However, a good business model enables physicians. Providing the best care for patients becomes so much easier when you are part of a successful organization focused on empowering doctors to provide this care.”

Patient Outcomes

When asked why he chose private practice and how he is able to balance that focus on patient care with the growing demands on the business of medicine, Dr. Cowan elaborated. “I wanted to help build an organization where it’s natural to continue to develop new ways to improve patient outcomes, lower overall healthcare costs, and create ways to allow providers to focus on patient care. Ultimately, this mindset led me to private practice, which has certainly exceeded my expectations.”

ENT Associates of Greater Kansas City is a progressive practice, which has pushed the envelope. It performed many of its sinus procedures in the office, which is a common trend in otolaryngology. It has been performing office-based image-guided sinus surgery for five years. It also moved many typically hospital-based surgeries to outpatient surgery centers or to their office, which has greatly improved access and lowered costs for its patients.

“We feel it is paramount to be leaders in improving patient access and decreasing the overall cost of care,” said Dr. Cowan.

For patients visiting the website of ENT Associates of Greater Kansas City, they will see the tagline, “Experience. Compassion. Trust.” Drs. Cowan, Walls, and Showmaker concurred that these values, in conjunction with collaboration and communication, are intrinsic in their daily interactions not only with their patients but also with physicians and staff.

“It boils down to communication on so many levels. We strongly encourage our providers to personally contact patients after procedures. A prompt response or acknowledgment goes so far. We do everything we can to build communication in our culture because timely responsiveness naturally drives a phenomenal experience for our patients, our physicians, and our staff,” said Dr. Cowan.

The website is an important tool and an essential component of the overall patient care strategy provided by ENT Associates of Greater Kansas City, and another way for the practice to commit to and demonstrate their core values to their patients.

“Patients only recall, on average, about 20 percent of what is said in an appointment, and we need there to be ways for them to come back online and reinform/re-educate themselves about what happened in clinic. Accessibility is a key component to meeting the needs of our patients to improve satisfaction and reduce any anxiety surrounding their care. When our voices and words are on the website, we are ‘accessible’ 24 hours a day,” said Dr. Showmaker.

In Atlanta

All three will be attending the AAO-HNSF 2018 Annual Meeting & OTO Experience in Atlanta, Georgia, to further enhance their commitment to excellence in patient care via education opportunities and networking with colleagues from around the globe. Beyond the Annual Meeting, they shared that the value of being members of the Academy allows them to focus on the patient sitting right in front of them.

“We are on the front lines, looking right at the tree. It is good to know that the Academy has our interest at heart and is looking at the 30,000-foot view of the ENT forest. It is important that physicians are involved in the membership. We can trust that what is happening on the political level is being taken care of by the Academy and will be channeled into our practice,” said Dr. Walls.

In addition to the political and advocacy wins spearheaded by the Academy, Dr. Showmaker noted the value of staying abreast of the discussions on ENTConnect as an opportunity to collaborate with experts from across the country. “It’s extremely important to be at the table when decisions are made,” he said.

The challenges faced by medicine today are often the topic of discussion on ENTConnect, and many of those discussions focus on the future vitality of private practice.

“ENT Associates of Greater Kansas City has created a sustainable and successful model that allows our physicians and staff to thrive both professionally and personally. Our growth is anchored by our never-ending commitment to patient satisfaction. As a truly physician-led organization, we easily evolve with the changing medical landscape to provide the best care for our patients. We’re extremely excited about the future of medicine, as we believe physician-led organizations will be poised to improve accessibility, affordability, transparency, and quality,” said Dr. Cowan.