I sit and think a lot since I exited my career as a podiatrist. Thinking and creativity are nice but there was little extra time to think while running a busy foot and ankle practice. Creativity in medicine and surgery becomes malpractice if you deviate from the standard of care.
My current part-time job expects thinking and creativity since my hospital employer now calls me a physician-consultant. My handler, the 40-year-old MD to whom I report, gives me problems to solve that pertain to delivery of healthcare and community benefit projects.
My best creative thinking happens while sitting in a lawn chair, camped by a lake. I guess I can’t call it camping since living in an Airstream is hardly roughing it. My mind goes dead in committee meetings even when I’m chairing the gathering. The real creative stuff emerges out in the woods.
I spent last week camping with my granddaughters. My creative time had to be shared with very active 7- and 10-year-old girls. This was still more productive than a committee meeting with a green-belt facilitator helping me develop consensus so we can sell our ideas to mid-management, who then take credit for the idea if it works when they peddle it to the higher-ups.
Between bike wrecks, urgent trips to the girls’ bathroom and run over frogs, I was ordering a book on my Kindle e-reader and a new bicycle tire. I executed the order with a “one-touch” keystroke. My Kindle instantly downloaded the book and the bike tire shipped.
This exercise stimulated my thinking-creative thing. Why does the delivery of healthcare have to be so complex? We have electronic health records, which do little for the patient and, in many cases, triple the workload of the doctor. Now we’re getting ICD-10, which practically none of the physicians want. The beauty of all this is that the high level executive leaders can monitor medical care from a distance like air traffic controllers watch numbers move on a radar screen.
I looked at my Kindle and asked myself, “How would Jeff Bezos, CEO of Amazon.com, handle the delivery of healthcare in America?”
Better yet, what if we turned the problem over to Jeff Bezos, Bill Gates, Warren Buffett and Martha Stewart? I’m guessing that if we turned this mess over to a group of geniuses who could simplify a complex system to the point that an old man like me could understand it and use it, it would work.
When I order a book or a gadget from Amazon, I get a clear description of it. I get reviews from other customers who have read the book or used the gadget, and the price is discounted because of the direct communication between the buyer and the source.
I would love to manage my healthcare in this simple and understandable fashion. It would be so nice to surf a site like Amazon for a list of providers and their patient reviews and their track record of successes and complications. With one click, I would schedule my appointment with the doctor who best fits my needs.
In order for geniuses to help solve the problems with healthcare delivery, the herds of bean counters and diagnostic coding wonks are going to have to accept that the current model for healthcare reform may be a stillbirth. They have to step back and let the geniuses redesign a simple and useable model of healthcare delivery. The problem is that they probably won’t.
We are blessed with a culture of business types who have taken charge. Healthcare leadership is very lucrative. Review the statistics for the compensation of leaders in the non-profit sector. Seven-figure annual incomes are not unusual. The administrative higher-ups are not going to jump off this gravy train even though it is about to derail.
Physicians and patients are losing control of healthcare to political types and business types. The tail is officially wagging the dog in healthcare.
There is a reason why I would like a team of geniuses like Bezos, Gates, Buffett and Stewart to redesign healthcare. They have all created successful changes in their industries that likely did not evolve from a committee meeting.
In the meantime, we have this unsustainable quagmire that works well for the MBAs on top who continue to skim off the cream. If a new design was to evolve, I’m sure there would be plenty of jobs in laundry and food service to keep our ousted leaders off the street.
Now back to that new novel on my Kindle.
Dr. McCord retired in December 2008 from practice at the Centralia Medical Center in Centralia, Wash.