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Collisions with the healthcare sector usually generate tworeactions. The first is tremendous respect and appreciation for the individualswho provide the care. Their focus on patients and outcomes is intense and theirfrustration with the system within which they operate is equally so. The secondis near despair at the attitudes of some, perhaps many of those sameindividuals, 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, thisis a little problematic. Discussions recently with two people who I have theutmost 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 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 timefor action! The problem was well defined in 1999, so we must allow common senseto 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 tobetter operatives and better outcomes. It is obvious, and if you doubt thatthere are numerous examples from the airlines, forklift drivers, miningoperations 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. Healso added that the Simulation and Training piece was one element of theequation, ‘along with better training we need standards, SOPs and an appliedsystems approach to ensure safety-based operations.’ Yes, without doubt.
Can Healthcare Care?
As an industry I doubt it can, though there are a number ofshining examples of those entities that do and have acted to improve theirpatient outcomes and their businesses. It really does not matter which of thosewas their priority; those responsible for providing care should push thepatient agenda, those needing to keep the doors open should focus on the bottomline. The two approaches are complimentary.
Business people should focus on staff well-being, that toois critical to both the outcomes and the business.
With many MDs approaching burn out, and the suicide ratedouble that of the general population, many healthcare providers are seeking toget out as soon as possible. More future caregivers are deciding on a cheaperdegree that may generate less dolars, but still a very good return, and doesnot lead to paying student loans throughout their career AND liability ifthings go wrong.
Most predictions of staffing levels have likely not factoredin these more recent changes and the already startling shortfalls are likely tobe far worse than predicted. “Healthcare” is going to have to make itself a farnicer and safer place to work. Money alone, i.e. salary, won’t do it.
Technology, not theanswer
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’ bypiling on ever more useless form filling and box ticking, not much of it to dowith the business of making people well.
Are they all deluded and do we need a modern healthcare Catothe Censor to come up with a modern close to all articles and speeches – not ‘Carthagemust be destroyed,’ but ‘Invest in your people!’