Aiming For The Moon

       A good friend told me recently that he thought big healthcare institutions understood more than anyone what changes are needed in our system and what changes are coming. But they are still making money now so if doesn’t make sense to change. In essence they were going to “ride that horse until it dies.”  Maybe then they would change.  The incentive to stay the same is still higher than the incentive to change.
       The same could be said for primary care in general. The rumors of primary cares’s demise have been around for years but there really are more and more reasons to be pessimistic and the future. Downward pressure of wages, increasingly mind numbing work, the insanity of EMRs and the rise of Advanced Practitioners all threaten the future existence of PCPs.  And we haven’t even begun to see the effects of AI on simple medical issues.
       The entrepreneurial space is fantastic for inventing the new ways we might seek healthcare in the future.  Entrepreneurship allows one to dream big and set lofty goals.  That’s not always an option for those of us with medical school loans and those entrepreneurial start ups eventually need the big giant healthcare institutions to succeed, the ones that really don’t want to change.
       All of this may be true or none of it could be. But why not make a big gamble in that space between healthcare giants and rocket-propelled start ups?  Why not shoot for the moon?  Why not try? If you fail, well, the system is failing anyway. If you succeed even a little you will have made a difference.   That is what I want to rededicate myself to.  Let me know what you are doing.  Would love to hear from and support anyone wanting to make a difference.

Lenses to look at Healthcare

When I was at that the American Telemedicine Association Conference #ATA18 earlier this year one of the speakers was taking about the lenses to use to help us make decisions. She felt the if we looked at healthcare, specifically technology in healthcare, through the a specific 4 part prism we would find better solutions. Those 4 point were whether or not something was Accessible, Affordable, Reliable and Relational. If a new product, service or piece of technology couldn’t compete on those four pillars than it likely was bring no value to patients, physicians or the healthcare system as whole.

Accessible, Affordable, Reliable and Relational have become a mantra for me. I try to apply it to any decision now within healthcare. If I am involved in creating a new policy, I want to ask myself, how will this policy affect a patients ability to Access care? Will it it improve it? If it doesn’t then it might not be the right decision. Can patients afford it or can the healthcare system afford to provide it? Is it an unfunded requirement of physicians and advanced practitioners who may be required to do more work without any compensation? Does it strengthen the bond between a patient and their doctor?

What lenses are conspicuously absent for this set of 4? The insurance company and other payors. They do not factor much in this and they tend to dissuade Access with narrow networks, the prevailing sentiment among patients and physicians alike is that insurance is neither affordable or reliable. And who feels like they have a good relationship with their insurance company? In addition, the Direct to Consumer healthcare market will continue to grow and that is the population of people who would be most interested in the topics I write about.

In future posts, especially Health App of the Month, there will be an addition to every article. The ability of an app or service to be Accessible, Affordable, Reliable and Relational will be evaluated. Would love to hear any feedback on this from my readers.