Another hypothetical for consideration.
So imagine two competing health care systems. One is top-heavy with MBAs who view health care as another commodity. Honestly can’t blame them. It’s what they were taught in school and it’s all they know. In addition, it has been the strategy to win the bottom line grind of corporate health care over the last few decades. Every major decision is made by people who have never been in a room face to face with another human being facing a potentially life threatening illness. They can’t make decisions based on the best care because they don’t know care. And while there may be a message to the public that the organization is led by physicians this is simply a marketing ploy. The physicians are simply chess pieces. The only feedback from administrators is monthly profit and loss statement. There is no channel for feedback from the front lines. The relationship between physicians and administrators becomes contentious. How could it not? A few physicians have the fortitude to fight the good fight. The majority, however, simply begin to dislike their work environment and question their career decisions. If they don’t enjoy their profession what would motivate them to become better at their work?
Across town at the competing health system a new visionary leader has just been put in place. This new leader knows that if health care hasn’t hit rock bottom it is pretty close. This person realizes that the successful health care system of the future will look very different from the those of today. The focus will finally be on quality and not volume. This new leader acknowledges that you can’t administrate quality. Rather, the idea is to recruit a medical staff committed to quality and then provide the physicians with the best possible environment to practice medicine. A culture evolves. Financial data will be shared freely with physicians so that they can also practice cost-effective quality health care. With autonomous physicians the administrative payroll can be slashed realizing a significant cost savings. The administrative staff that remains will be committed only to helping clinicians deliver better care. They are renamed facilitators.
The new system becomes a great success. Physician from all over apply to be part of this change. More importantly, patients come from all over to experience quality and cost-effective health care. This new system is a winner simply because it has the best doctors practicing the best and most cost-effective medicine.