Monthly Archives: November 2014

Relationships Over Transactions

Is there a single fix for health care?  Probably not.  It’s a really broken system that involves a lot of money, a lot of waste, and lot of unnecessary people, processes and rules that consume precious resources with no return.  The much-needed complete overhaul frightens many because the overhaul involves the people factor.  And the CFO doesn’t know how to talk to the board of directors about the people factor.  It’s difficult to measure the impact of a healthy culture and health relationships on a month to month basis.

More than any other industry health care is about people and their relationships.  People and relationships are more important than big data.  More important than any new processes or procedure.  More important than new penalties or incentives.  More important than the patient experience as it is currently being described.  Healthcare needs to focus on people and their relationships.  The patient-physician relationship.  The provider-provider relationship.  The provider-payer relationship.

The physician-patient relationship is ground zero for healthcare.  A high-value location with the potential for the biggest impact.  It is where the greatest improvements in quality can be made.  It is where cost control begins.  It is the ultimate component of the patient experience. Unfortunately, corporate medicine based on business principles has replaced a physician-patient relationship with a physician-patient transaction.  Volume driven healthcare with the focus on simply getting as much done as possible.  And the two most important stakeholders in healthcare, patients and physicians, have allowed it to happen.  Patients have lowered their expectations and physicians have cheapened the profession.  Re-establishing and optimizing a physician-patient relationship is a must for value-based healthcare that focuses on quality and succeeds at controlling costs.  The physician-patient relationship is the foundation of healthcare.  Transitioning from transaction to relationships will be problematic in that relationships require time and in the current system the value of time is not appreciated by anyone but patients and physicians.  Is it wrong to assume that healthcare will improve if we give patients more time with their physician?  More time to listen.  More time to educate.  More time to discuss the risks, benefits and costs of all options.  More time to develop a relationship.

The provider-provider relationship also needs to be addressed.  A culture of collegiality focused on patient care is imperative.  Everyone has an important role to play.  One can’t administrate the culture.  It is about getting the appropriate people in key positions and allowing them to be role models for the new culture.

Lastly, providers and payers must establish a better relationship.  The current business speak describes the concept of alignment.  This will require both sides overcoming years of mistrust and antagonism.

The transition from transactions to relationships won’t be easy.  Administrators and payers currently focus on volume.  Physicians have been rendered powerless.  It may require a revolution that starts with the paying customer, the patient, to simply demand more.