A Service Industry

If you change how they think then you will change how they act.

In this case, “they” refers to physicians.  Many of the posts here at HCR have been critical of the cost, inefficiency and ineffectiveness of corporate health care and the non-providers who are in charge.  However, the most important posts at HCR are those that ask physicians to look in the mirror, reassess the state of the profession and take charge of reforming the system.

What is the best pathway to change and reform the activities and behaviors of a profession?  One can apply external positive and negative reinforcement to good and bad behaviors.  Alternatively, one can change the thinking that leads to behavior.  In other words, one can change the culture!!!  As mentioned in previous posts the concept of culture is at times difficult for the bottom line grinders to appreciate.  Difficult to define, measure and manage.  However, it is the unwavering belief of HCR that establishing a new culture for physicians and other providers is easier than it may seem and is the only pathway to meaningful change in the health care system that results in an improvement in quality and a reduction in cost.

Organizational culture has been defined in various ways by many management experts and anthropologists.  One of the common themes in the definitions of culture links thoughts to actions.  The thought components have been described as values, norms, and beliefs.  HCR is constructing a framework for health care culture that will define the important values and priorities for physicians and other providers.  At the same time HCR will develop the strategies necessary to allow the values and priorities to evolve into a culture with measurable improvements in quality and cost.

One of the most important values to establish in the health care system is that of service.  Health care is above all else a service industry.  Perhaps the most important service industry.  Health care needs to prioritize and value service above all else.  For physicians there is a service obligation to many but most importantly there is a service obligation to patients to provide evidence-based, humanistic and cost-effective health care.  Physicians also have a service obligation to their colleagues and other providers to be an effective part of a multidisciplinary team.  There is a service obligation for physicians to educate and mentor those in training and there is a service obligation to the general public to be productive citizens.

Service is one of the principle values/priorities on which HCR will create the successful cultural change in health care.  While others look to change behavior through process HCR will change behavior by changing the way physicians think.

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