The Paradigm Shifts Needed in Healthcare

The Paradigm Shifts Needed in Healthcare
Author Information (click to view)

Halee Fischer-Wright, MD

Dr. Halee Fischer-Wright is the author of “Back to Balance:  The Art, Science, and Business of Medicine.” A nationally recognized physician leader, healthcare executive, and former business consultant, she is president and CEO of Medical Group Management Association (MGMA).

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Halee Fischer-Wright, MD (click to view)

Halee Fischer-Wright, MD

Dr. Halee Fischer-Wright is the author of “Back to Balance:  The Art, Science, and Business of Medicine.” A nationally recognized physician leader, healthcare executive, and former business consultant, she is president and CEO of Medical Group Management Association (MGMA).

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There’s a lot wrong with healthcare today. Especially the medications they have now a days and all the side effects. Just like the prescription xarelto, check out the xarelto lawsuit June 2017. The average physician spends 2 hours on paperwork for every hour spent with patients. One in twenty patients is misdiagnosed daily. Only 34% of Americans have “great confidence” in the leaders of the medical profession.

The fundamental problem is that the art (how we care), science (how we treat), and business (how we pay) of medicine have fallen out of balance. As a result, we have lost our focus on strengthening the one thing that has always produced healthier patients, happier doctors, and better results: namely, strong relationships between patients and physicians, informed by smart science and enabled by good business.

To bring healthcare back in to balance, we need to make several fundamental paradigm shifts away from old ways of thinking and toward the new.  These changes will pave the way for the innovative solutions necessary in healthcare today.

 

From Money as an Incentive to Time as an Incentive

It’s never been easy to practice medicine. Today, the stimulant used to encourage “good physician behavior” is money, in the form of incentives intended to ensure that boxes are checked and penalties that are imposed when they are not. We shouldn’t be opposed to incentives that reduce waste or achieve lower costs, but only if those things are done with the patient’s welfare in mind first and foremost—meaning only if the time needed to carry out the art and science of medicine is factored in. Rather than starting with the question “How do we use money to reward good behavior?” we should insist that payers and lawmakers  instead ask, “How do we use time to encourage good outcomes?” It’s time we give our practitioners the time they need to establish the trusting relationships and deliver the care necessary to achieve the outcomes we all desire.

 

From More Complexity to More Simplicity

So many well-intentioned healthcare laws have morphed over time into something much bigger. Layers simply keep getting added on, year after year. The laws and regulations governing Medicare alone, which ran for fewer that 1,000 pages when it was first passed in 1965, now run for more than 130,000 pages—all of which are active and in force. Healthcare is now second only to nuclear energy as the most complex and regulated industry in America.

What if health regulators agreed that for every new responsibility they want to require of patients, physicians, or medical practices, they first take one away? What would happen if we defined a national standard that at least 75%  of physicians’ time  had to be reserved for direct patient care—not on billing or EHRs or checking boxes? What if, by the year 2020, all EHRs in America were required to speak the same language and fluidly talk with one another? What if we could simplify billing to require only a single form, no matter where you went? The list of industries–from banking to technology to aviation–that have worked hard to simplify in the face of complexity to improve experience and safety goes on and on and on, while in healthcare, the reverse is happening.

 

From More Metrics to More Relationships

What looks good on paper and what drives the best medical outcomes can be two very different things.  When we consider the costs of abiding by and tracking and reporting the metrics that are required today—in physician time, care team time, and the $8 billion we spend as a nation every year—it’s pretty clear that we’re interfering with those best, relationship-building approaches.

Instead of spending so much of our national time, resources, and attention in medicine on creating artificial metrics designed to incentivize good physician and provider behavior while unwittingly reinforcing bad behavior, let’s give the art of medicine the room it needs to build trusting relationships in the way that the best doctors and medical practices have always done: honestly, naturally, compassionately, and with the best outcomes for the patient squarely in mind.

And this is just the beginning. I believe these shifts, and others, are the starting point for initiating a new conversation about how we can move American healthcare past the mediocrity we are settling for today to reach for–and achieve–excellence once again.

 

The above is adapted from “Back to Balance: The Art, Science, and Business of Medicine” (Disruption Books) by Dr. Halee Fischer-Wright. Copyright (c) 2017 by Halee Fischer-Wright. All rights reserved.  This book is available at all bookstores and online booksellers.

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