Written by Andy Smith, MTM publisher
Collisions with the healthcare sector usually generate two reactions. The first is tremendous respect and appreciation for the individuals who provide the care. Their focus on patients and outcomes is intense and their frustration with the system within which they operate is equally so. The second is near despair at the attitudes of some, perhaps many of those same individuals, and almost all academics, when the question of improving or, heaven forbid, changing the healthcare way of doing things is discussed.
As improving healthcare will definitely involve change, this is a little problematic. Discussions recently with two people who I have the utmost respect for highlighted the conundrum that is modern (US) healthcare, one from industry and the second from academia.
My friend from industry is doing well from a business perspective. He wants to see universal change in the way clinicians are taught and trained (because that is what is needed, not because it is good for business, though it would be). He ruefully shook his head and said ‘it will be 15 years before the entire industry does the right thing’ and followed that up saying ‘we need to get academics out of the discussion.’ I have to agree having attended attended a two-day meeting led by academics at which they stated ‘best is the enemy of better’ and then frittered away most of the time available trying to define ‘best.’
By all means continue the research but it is now past time for action! The problem was well defined in 1999, so we must allow common sense to take over. We must go for better, preferably a lot better and then improve, not continue to argue that we need to prove that better training leads to better operatives and better outcomes. It is obvious, and if you doubt that there are numerous examples from the airlines, forklift drivers, mining operations and crane operators to prove the case.
My second colleague, for whom I have equal respect, suggested we need more research on achieving better training. No, we don’t. He also added that the Simulation and Training piece was one element of the equation, ‘along with better training we need standards, SOPs and an applied systems approach to ensure safety-based operations.’ Yes, without doubt.
Can Healthcare Care?
As an industry I doubt it can, though there are a number of shining examples of those entities that do and have acted to improve their patient outcomes and their businesses. It really does not matter which of those was their priority; those responsible for providing care should push the patient agenda, those needing to keep the doors open should focus on the bottom line. The two approaches are complimentary.
Business people should focus on staff well-being, that too is critical to both the outcomes and the business.
With many MDs approaching burn out, and the suicide rate double that of the general population, many healthcare providers are seeking to get out as soon as possible. More future caregivers are deciding on a cheaper degree that may generate less dolars, but still a very good return, and does not lead to paying student loans throughout their career AND liability if things go wrong.
Most predictions of staffing levels have likely not factored in these more recent changes and the already startling shortfalls are likely to be far worse than predicted. “Healthcare” is going to have to make itself a far nicer and safer place to work. Money alone, i.e. salary, won’t do it.
Technology, not the answer
According to a recent Forbes piece by healthcare tech CEO Morris Panner, MDs now spend twice as much time filling out EHRs than they do consulting with patients. No wonder MD’s want to get out. That is not what they signed up for and is a classic example of a great tech idea being poorly deployed. Voice recognition and voice-to-print should take care of that issue. If those conversations were recorded, the MD’s life would be simpler and the patient would understand more and have more time with his/her doctor.
Despite this, healthcare in general is relying on technology, from AI to robots, to solve its future issues, while government ‘helps’ by piling on ever more useless form filling and box ticking, not much of it to do with the business of making people well.
Are they all deluded and do we need a modern healthcare Cato the Censor to come up with a modern close to all articles and speeches – not ‘Carthage must be destroyed,’ but ‘Invest in your people!’