Wednesday, September 19, 2007

Hillary, Rudy, Ted in Ohio et al….please help!

In a recent meeting with several physicians, we were discussing all the changes that health care providers must deal with that are non-clinical in nature. As frustrating as it might seem to patients, it has been increasingly so to doctors as well.

More than half their time seems to be spent on non-clinical matters, helping their patients navigate the health care system maze or on billing activities trying to get paid by insurance companies. This last Friday on 20:20, the final segment showed a primary care physician who dropped all insurances and would only accept cash. He lowered his overheads, seemed to have more time for his patients and his income stayed the same. In a recent seminar that I attended material was presented on a RAND study done in Ohio several decades ago. This study found that when patients paid a greater percentage of their health care costs they used 31% less care with no significant outcome differences.

So, let’s design a system of caring and health that lets doctors practice and doesn’t require them to get another degree in accounting or information systems to get paid for their work. Next, make sure patients have enough incentives to learn to be good buyers of health care services.

So what’s next? Transparency. Health consumers need information on actual out of pocket expenses in advance of service. Sorting out value will be a bit more complicated; however, the quality information that hospitals, doctors and insurance companies possess needs to be shared in ways that help patients purchase health services. We also need to get this information into the hands of doctors and other health professionals who can assist their patients in determining the best value.

Now here is where we could use help from our legislators. Last time Hillary tried to get more information out there the insurance industry had a lot of lobbying money, and the Republicans turned her plan into waste material. Of course I am on dangerous ground here because I too didn’t like the plan. My point here is that the governor of Ohio has a task force working on these issues and I am not sure that any doctors or hospitals are on it. I hope Ohio can take the lead in developing something that both Ohio Democrats and Republicans can get behind because, the big picture for Ohio and the U.S. is for us to be a lot more competitive, after all our health care costs are killing us. Being too idealistic? It never hurts to dream big.

With all these pressures it was refreshing to hear comments from local doctors last week as they were discussing their own frustrations in running their practices; whatever they do they agreed the bottom line was to do whatever it takes to care for their patients. After that they would focus on running their practice or how to work better with a hospital.

Friday, September 7, 2007

Not there yet but we are getting closer…building our dream of becoming the best Community Hospital for the State of Ohio

Last Friday, several hospitals from the Cleveland Clinic network visited us and I had a chance to reminisce about changing the culture at our hospital. To borrow a line from W. Edwards Deming, “America has the greatest and most productive workforce in the world, all it needs is leadership who believes in them."

The culture of an organization certainly is a leadership issue. Well at ACH/Planetree I have gotten a lot of credit for many of the wonderful things we have achieved and do everyday, but I will be the first to admit we just have a great team of talented individuals who get to practice their professions in an environment that they helped create. What we have done as an organization is create an atmosphere of shared beliefs and values that makes us feel good and is appreciated by our patients and guests. What was wonderful to hear was how our guests perceived our colleagues and their level of genuine engagement.

Postscript to my very first blog. I was saddened to learn that the physician practice decided to discharge Susie’s mom from their practice. Even in the movie, Miracle on 34th Street, Santa sent a customer to Gimbels for the one item they were searching for because Santa cared about the value to the customer. There is an old expression, "let the buyer beware.” Well the new expression will be “let the seller beware.” The end result for Macy’s, they are still around today. Hospitals and doctors, the world is changing quicker than ever; let’s help educate our customers and serve them well. What has always made us special in the eyes of our patients is their trust. There are rough times ahead and as long as we continue to keep that trust of “patients first” we will all be better off.