The seven deadly sick care sins
Arlen Meyers, MD, MBA
President and CEO, Society of Physician Entrepreneurs, another lousy golfer, terrible cook
Once again, the US has been ranked last in health system performance. The report notes that despite having the most expensive health care system, the United States ranks last overall compared with six other industrialized countries—Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom—on measures of quality, efficiency, access to care, equity, and the ability to lead long, healthy, and productive lives, according to a new Commonwealth?Fund report. While there is room for improvement in every country, the U.S. stands out for not getting good value for its health care dollars: it spent $7,290 per capita on health care in 2007 but ranks last among seven countries. The Netherlands, which spent $3,837 per capita on health care that year, ranks first.
I believe whether a country has a lagging, expensive, low value sick care system, like the US, or a high performing healthcare system reflects its values. In the case of the US that includes, among others, a particular work ethic, valuing personal responsibility, capitalism and the profit motive, a belief in US exceptionalism, freedom, accepting market and social driven inequities, a distrust of centralized government, and meritocracy.
What's more, despite all the American chest thumping, Germany has broken South Korea's six-year reign as the "the most innovative nation in the world,"?according to the latest Bloomberg Innovation Index.?The US ranked ninth, while China came in 15th.
We find ourselves, once again, in this sick care ranking because we've committed the 7 deadly sins. The seven deadly sins are pride, covetousness (also known as avarice or greed), lust, anger, gluttony, envy, and sloth.
PRIDE: ?a sense of one's self-worth that is out of proportion to reality. The professed worth of shiny new objects won't get us out of the sick care mess.
LUST: a desire for pleasure of beating your competition and being the best of the rest at all costs, even if it contributes to destroying the planet.
ANGER: the excessive desire to take revenge on your political opponents
GLUTTONY: biting off more than you can chew or fund and the unwillingness for all the stakeholders to say,"enough"
ENVY: sadness at the good fortune of another, whether in possessions, success, virtues, or talents.
SLOTH: laziness or sluggishness when facing the effort necessary to perform a task.?These days we call it quiet quitting. Is that why innovation is dying?
“Taken together, a ‘perfect storm’ of pressures on radiologists and their institutions is brewing,” lead author Bettina?Siewert,?MD, a professor of radiology at Harvard, and colleagues wrote Oct. 29. “Solving these issues will not be easy; this is a collection of ‘wicked’ problems defined as having (1) no stoppable rule, (2) no enumerable set of solution or well-described set of permissible operations, and (3) stakeholders with very different worldviews and frameworks for understanding the problem.”?
The seven sins:
领英推荐
1. Reimbursement
2. Corporatization
3. Workforce shortages
4. Waste and abuse of image appropriateness
5.Burnout
6. Turf wars
7. Workflow friction.?
American "values" are enshrined in our founding documents and culture. That is different from what segments of the American population value and the definition of economic value. Here are some tips on how to stay true to your values.
The BIG FIX, transforming sick care to healthcare, starts in Congressional hearing rooms, not in a doctor's examining room. That means we have to practice not value based care but instead rethink "values based care".
Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Substack