They don’t understand. They can’t understand. They probably would rather not understand. Health care administrators and managers and insurance executives can’t understand what it is like to provide health care face to face with another human being.
The training of health care administrators, managers and insurance executives is based on spending two years in business school studying topics such as accounting, finance, marketing, human resources and operations management with some electives in an area of concentration as well. The goal of this training is to eventually sell something to someone. The product is irrelevant and the focus is always on the bottom line. Any human interaction is a means to an end.
In comparison, physicians spend a minimum of seven years in training (often more) and in general all but the first two years involve daily contact with other human beings who have a potentially serious health concern. The goal of this training is to deliver quality health care. Human interaction and relationships are the foundation of the profession.
To a business school graduate the product doesn’t really matter. The unit of production is irrelevant. Make as many as you can as cheap as you can and sell them at the highest possible price. Time and people are expenses that ideally are minimized. No time for a relationship in this model. The mentality is that health care can and should be sold and delivered just like any other product or service. In fairness, health care was in need of efficiency however this grind has passed the point of diminishing returns. Cost cutting at the level of care delivery is now compromising the ability to deliver quality health care. And sadly patients and physicians have accepted the current model.
Physicians are well aware that health care can not be managed like any other abstract unit of production. Health care is based on a relationship between a patient and a physician and relationships take time. In addition, the relationship time is usually different for each patient. The training is long and difficult for a good reason.
Alignment is a hot topic right now. Physicians, other providers, hospitals and insurers must all be working together to deliver value focused health care. The adversarial and antagonistic atmosphere that exists must be eliminated before the health care system will improve. Two years of business school, or even a 20 year career in an administrative suite, can not begin to allow a health care administrator or manager to understand what health care is like on the front line of health care delivery. Therefore, HCR is proposing that all administrators, insurers and managers be required to spend time with physicians and other providers. A busy day in the office or operating room. Administrators need to see close-up the human interactions that are such an important part of quality health care and that can not be streamlined like an assembly line. And they need to watch it all as if the patient was one of their own family. Would an administrator who spent the day with a busy oncologist really wonder why he/she can’t see 5 more patients a day after watching him/her spend 45 minutes with a young mother just diagnosed with cancer?
And maybe to be fair health care administrators and insurance executives can have a “Bring Your Doctor to Work Day”. Guess is that providers would be able to review with them all of the people and processes that cost money and do nothing to make care better.