In 2006, Michael Porter, the well-known Harvard economist and business guru, wrote Redefining Health Care: Creating Value-Based Competition on Results. Now, 17 years later, our industry struggles with the same unsolved problems:
There is no clear set of standards for best practices
- There are profound imbalances in care, within and between institutions, payer compensation, quality of care, and access to care.
- Costs are too high and rising, and they need to correlate with quality of care.
- Information technology tools, particularly EHRs, must be implemented to facilitate efficient clinical workflow and positive patient outcomes.
Any regular business would have already addressed parallel problems through policies, processes, and workflow changes.
Healthcare is a relatively new business entity. It began in the 20th century as an aggregation of different medical and dental services delivered by disparate independent practitioners, hospitals, clinics, and administrative support services. Before the commercialization of healthcare and its turn toward a for-profit industry, we had individual doctors and standalone hospitals providing as-needed care. Today, doctors are becoming employees of hospitals and clinics, hospitals are acquired to form chains, and leading pharmacy chains are purchasing independent pharmacies while expanding into primary care. Hospitals, formerly run by professionals trained in hospital administration, are transitioning to being led by MBA-educated executives who focus more on financial issues rather than patient care and serving the community. Even non-profit organizations focus on the bottom line, where surpluses lead to expansion of facilities and heftier end-of-year bonuses for senior leaders.
Irrespective of these changes, one factor has not changed. Healthcare will always be an interpersonal business. This is best illustrated by the hundreds of healthcare workers who risked their lives during the pandemic to save lives, especially the nurses and doctors who held a patient’s hand, offering comfort when it was too risky for relatives to do the same.
Author and philosopher Phillip Gabbard wrote in his book Thrivation:
“And in truth, believe it or not, the fact that we exist here and now, today, is simply a fantastic testament to humankind’s kindness, and thoughtfulness and mindfulness, and perhaps, just perhaps, if we continue to work together and continue to figure things out in a way that very well improves the experience for all, and not just some, then we could actually, no most definitely, elongate the opportunity for our people, our kind, our species to have a piece of what we have today, but just a tad bit better.”
By working together, constantly learning, and embracing change, we can make healthcare a tad bit better every day.
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