Impact of Physician Navigators: Looking beyond productivity metrics and silver bullets

We thank Mercuri and Mondoux for their commentary1 on our study which introduced Physician Navigators as a novel intervention to improve ED productivity and efficiency.2 The authors expressed concern about the potential trade-off between improved productivity and compromised patient outcomes, and described Physician Navigators as limited to improving timely care with potential negative consequences on the other dimensions of quality. This is a limited approach to understanding the utility of Physician Navigators. The Province of Ontario started to systematically tracked ED return rates to any hospital within 72 hours of discharge and rates of sentinel diagnoses (ie, missed acute myocardial infarction, subarachnoid hemorrhage, paediatric sepsis) within 7 days of discharge from an ED. Although collection of this data started after our study’s conclusion, our current rates of ED return and sentinel diagnoses …