Skip to main content

The Days Are Over When We Could Thrive By Bankrupting Our Customers

Writing in MedCity News, Dr. Westby G. Fisher (a.k.a. the blogosphere's Dr. Wes) offers one of the best forecasts I've seen of health care's future. 

Whether under Obamacare, AnyCare or WeDon'tCare, health care simply costs too much and delivers too little value in return.  And to most observers, the delta (the required magnitude of improvement) is way beyond a few percentage points, more like 20-50% - a challenge few providers can even fathom, let alone deliver.

Predictably and frantically, providers are responding by trying to get bigger, faster.   Buying everything in sight, merging with what can't be bought.  Yet the notion that, in health care, 'big' produces better, more economical results than 'small' is  (putting a charitable face on it here) decidedly unproven.   The next big health system merger that actually delivers on its efficiency-seeking promises will be the first.  (Oops, that's not charitable at all, is it?)

I'm told that spreading the cost of a very expensive EMR system over a bigger entity, for example, makes it more affordable for all.  Obviously it's better to divide $25 million a hundred ways instead of fifty.  I get the math.  I just wonder whether the problem is the math, the EMR or the strategy, which seems uncomfortably reminiscent of the Soviet Union building block after ugly block of apartment complexes.  They called them 'workers' paradises' but try coaxing heat from the radiators.

While I was writing this, a quote came across my e-mail transom:
"Here's to the crazy ones. The misfits. The rebels. The troublemakers. The round pegs in the square holes. The ones who see things differently. They're not fond of rules. And they have no respect for the status quo. You can quote them, disagree with them, glorify or vilify them. About the only thing you can't do is ignore them. Because they change things. They push the human race forward. And while some may see them as the crazy ones, we see genius. Because the people who are crazy enough to think they can change the world, are the ones who do." (Steve Jobs)
I'm a contrarian.  I love being small and nimble while everyone else gets big and slow.   For a 20-50% improvement, health care needs small and nimble, needs paradigm-busters, innovators, maybe a few trouble-makers.  It does not need big for bigness's sake or because the herd's warmth feels so good.   Herds occasionally run off large cliffs, taking their consultants with them.

And on the edge of health care's cliff is a big warning sign reading "The Days Are Over When We Could Thrive By Bankrupting Our Customers."  Who knew?  Apparently only a few troublemakers.


Popular posts from this blog

Being Disrupted Ain't Fun. Deal With It.

Articles about disrupting healthcare, particularly those analogizing, say, Tesla's example with healthcare's current state, are frequently met with a chorus of (paraphrasing here) "Irrelevant! Cars are easy, healthcare is hard." You know, patients and doctors as examples of "information asymmetry" and all that. Well, let me ask you this: assuming you drive a car with a traditional internal combustion engine, how much do you know about the metallurgy in your car's engine block? I'll bet the answer is: virtually nothing. In fact it's probably less than you know about your own body's GI tract. Yet somehow, every day, us (allegedly) ignorant people buy and drive cars without help from a cadre of experts. Most of us do so and live happily ever after (at least until the warranty expires. Warranties...another thing healthcare could learn from Tesla.) Now, us free range dummies - impatient with information asymmetry - are storming healthcar…

Becoming Consumer Friendly In Five Easy Steps...Or Not

An article at offers hospitals 5 steps to becoming more consumer friendly.

If you still think there's a secret sauce to your hospital becoming more "consumer friendly," these 5 steps are as good a place to start as any.  Unfortunately, it's a little like that old Steve Martin comedy bit where he says he'll teach you how to be rich. The first step is to go find a million dollars.

Step 1 from the article is realizing that "...a Medicare beneficiary with chronic conditions is different from a young mom who brings her kids in for an annual check-up." This is market segmentation for beginners, and, yes, one size decidedly does not fit all. I'm sure your marketing team's been saying this for a while.

Steps 2-5: have a strategy, metrics, a champion and resources. OK. Hard to argue with any of those.

But those things, alone or together, won't overcome culture. They're important components to be sure, but insufficient without a …

Behind Every Resume Is A Potential Customer...and Karma.

I recently heard from an executive colleague who, thanks to a merger, found herself looking for her next opportunity. Her story, probably depressingly familiar to many of you, was all about the big black hole of rudeness and non-responsiveness that so often sums up employers' attitudes toward candidates.

This colleague, thinking she'd see the healthcare world from a new vantage point, pursued opportunities with consultants, IT vendors, architects and other suppliers who, far from appreciating her solid resume, were like the 3 Stooges of clueless.

So back to a senior health system role she went, WHERE SHE NOW INITIATES AND MANAGES RFPs FOR SOME OF THE VERY SAME COMPANIES who wouldn't talk to her as a candidate, but profess their LOVE for her now that she's got money to spend on their services.

Not gonna happen. Any guesses who's off the RFP list?

I smiled when I heard her story, imagining the BusDev people working hard to grow the revenue pipeline, all the while b…