In his book Being Mortal, Atul Gawande describes the challenges families face working with the healthcare system.
Gawande, a Harvard surgeon, explains: “The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that medicine has had an incorrect view of what makes life significant. The problem is that it has had almost no view at all”.
To paraphrase Gawande, we spend a sixth of our economy on a healthcare system that acts as if it has lost sight of what it means to be human.
The adage “Every system is perfectly designed to get the results it gets” is a commonly used description of why healthcare is failing.
But in seeking a solution, it is important to remember that all aspects of healthcare are not failing. In fact, parts of the healthcare system have enjoyed decades of well above average financial returns.1
Understanding these areas of shining success is the key to understanding the failure of the system.
The following factors work behind the scenes to synergistically create both the system’s high margins and the suboptimal results for patients and employers:
- Research is frequently designed, funded, and written by pharmaceutical, medical device, and food companies,
- Lobbying of government officials has been estimated to yield a 50-fold return on investment,2
- Direct to consumer advertising is both ubiquitous and effective,
- Physician reimbursement is often higher when recommending a more expensive rather than a more efficient mode of treatment,
- Some “quality standards” serve industry rather than patient interests. This intrusion into the patient/physician relationship has eroded physician morale,3 and
- Commercial interests have successfully integrated non-scientific bias into the content of medical education.4
These six factors have successfully protected the industry from efforts to improve the value of healthcare. They are also behind many of the daily frustrations of hard-working healthcare professionals.
Taming a beast may be a great show for the circus, but because of the synergies noted above, taming the rising costs of healthcare by taking it on directly has been been a failed strategy. Our solution at Switch starts by staying out of the cage.
Breakthrough To Better,
1A Case of Dr. Jekyll and Mr. Hyde by Carl Myers, MD MBA
2The Pharmaceutical Industry’s Profitable Stranglehold
3Time Out – Charting a Path for Improving Performance Measurement
4A Historical Perspective of Pharmaceutical Promotion and Physical Education
Switch Conversations informs business leaders on the “whys”
behind healthcare ineffectiveness and how we can help.
Edition 1 – Solving a Well-Entrenched Problem
Edition 2 – A Case of Dr. Jekyll and Mr. Hyde
Edition 3 – Best marketing tagline of all time?
Edition 4 – Post-Truth Killed a President
Edition 5 – What’s an employer to do?
Edition 6 – Profiting From the Opioid Epidemic
Edition 7 – The Keys to Unlocking Better Decisions
Edition 8 – When Difficult Things Need to be Done Well
Edition 9 – Fixing Healthcare
Edition 10 – Beware of a Singing Cow
Edition 11 – Wise Reflections
Edition 12 – Warning: Reader Discretion Advised
Edition 13 – Can AI save healthcare? (Part 1)
Edition 14 – Can AI save healthcare? (Part 2)
Edition 15 – Can AI save healthcare? (Part 3)
Edition 16 – Embracing Reality to Improve Healthcare
Edition 17 – Everything I Needed To Know…
Edition 18 – The Eighth Circle of Hell
Edition 19 – So… What’s Our Solution?
Edition 20 – Protecting Integrity as a Core Strategy
Edition 21 – An Unadorned Legacy
Edition 22 – Time to Grow Up
Edition 23 – Against All Odds
Edition 24 – When Everyone Has Stopped Listening
Edition 25 – Focusing on What’s Important
Edition 26 – Don’t Give Up Your Shot
Edition 27 – Join the Goodhood
Edition 28 – Fixing Healthcare (Recycled)
Edition 29 – Taming the Healthcare Beast
Edition 30 – Leadership
Edition 31 – Better Health Requires Good Sense
Edition 32 – Little Decisions With Big Consequences
Edition 33 – Transformational Courage
Edition 34 – Transformational Courage – Part 2
Guest Post – Happy Thanksgiving! By Jeff Novick, RD
Edition 35 – Transformational Courage – Part 3