Operation: “Finding Marcia”


Integration of community-based cessation into the evolving healthcare system has taken on a new urgency since the passage of the Affordable Care Act.  Operation Finding Marcia is an attempt to further the goals of integration by facilitating the meaningful, bidirectional exchange of information between tobacco dependence treatment specialists and prescribing clinical providers.

1. What do we want?

Each TDT specialist will identify at least one provider within their catchment area that cares for tobacco dependent patients, and will establish the professional relationship necessary to both receive and request referrals for consultation and care.  All TDT specialists should be able to document this relationship, and describe the nature of the clinical information exchange.

2. Who can give it to us?

Any prescribing clinician within the specialist’s catchment area.  This includes, but is not limited to, primary care physicians, pulmonologists, cardiologists, psychiatrists, physician assistants, or nurse practitioners.

3. What do they need to hear?

The primary objective of Finding Marcia is to establish a shared approach to patient care.  TDT specialists provide value by virtue of their ability to provide behavioral counseling, and their ability to coordinate care across time, setting, and circumstance.  Healthcare providers add value by virtue of their ability to identify tobacco use among their patients, direct smokers toward treatment, and provide sophisticated, multidimensional interventions.

4. Who do they need to hear it from?

Directly from TDT specialists.

5. How can we get them to hear it?

TDT specialists are encouraged to begin by engaging providers in case-oriented conversation.  Ascertain providers’ willingness to receive referrals for patients who require ongoing  care.

6. What do we have?

Professional credentials.  Ready access to healthcare providers.  A complimentary skill set.

7. What do we need to develop?

Skills in case-based communication.  Efficient methods for transmitting information (e.g. letters, etc).

8. How do we begin?

Each TDT specialist will engage at least one healthcare provider prior to the workgroup meeting scheduled for November 2012.  TDT specialists should come to the meeting prepared to discuss their experience.

9. How do we tell if it’s working?

Number of meaningful provider relationships with demonstrable evidence of bidirectional sharing of clinically relevant patient information.


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