This post is the third in an ongoing "CEO Article of The Week" original content series written by Integral Leaders in Health Founder and CEO, Spence Taylor, M.D. New articles on various topics related to our organization's purpose will be published each Monday.
South Carolina is experiencing a medical care crisis where patient well-being is no longer the top priority, and the components of the medical environment (doctors, hospitals, payors and universities/innovators) seem unbalanced and patient dissatisfaction is at an all-time high.
Do you have a financial advisor – a professional wealth consultant? Many people do. The wealth consultant meets and works to understand their client’s retirement goals, income needs, plans for the future, their concerns, their anticipated long-range expenses, and their financial risk tolerance and other matters concerning their personal finances.
Using that, they help formulate and implement plans and use periodic meetings to ensure everything is happening correctly. Notice what the financial advisor does not do. They do not tell people how much money they should make, what jobs they should do or when to retire. They do not tell them how much to spend on long-range expenses. They do not mandate a particular plan. People are free to accept the advisor’s advice or turn it down. While the investment strategies might be similar to others, the plan is unique. In other words, the financial advisor works to achieve the shared financial goals created by them and their client.
Why doesn’t medicine work this way?
Perhaps it did a century ago when the medical care environment consisted only of the doctor and a relationship with a patient. Just like the financial advisor, patient well-being was simply defined as achieving shared health goals created by the patient and the doctor. Unfortunately, as the medical care environment became more sophisticated, however, our capabilities improved. Today the medical care environment includes not only the doctor, but also hospitals, payors and universities/innovators (the healthcare industrial complex) – all ostensibly working to support patient well-being. But with these additions, something else happened. Third-party outcomes were born – best practices, standards of care and clinical guidelines for care. Though well-intentioned, these third-party outcomes slowly replaced the achievement of shared goals between the doctor and patient as the measure of success in medicine.
Notice from where these third-party outcomes originated. They came from the “third-party” components within the environment – doctors, hospitals, payors and universities/innovators. They include such things as cancer screening best practices, chronic disease management parameters, care that is covered by insurance and care that is not. Even the performance of annual physicals is tracked as a statistic. And of course, it is impossible to watch television without hearing ads about what pharmaceuticals we should be using.
Notice, too, how the role of the patients has changed. They are no longer decision makers – they are the “objects” by which third-party outcomes are measured.
Whether intentional or not, the medical care environment has seemingly become all about itself -- not the patient. Competition among its components has resulted in an imbalance where doctors, hospitals, payors and universities/innovators have – intentionally or not – placed their own concerns above those of patient well-being (the shared goals between the patient and the doctor). This is the crux of the Medical Care Crisis.
It is important not to confuse medical care and the Medical Care Crisis with healthcare and the healthcare crisis. The term ‘healthcare’ generally refers to the massive, multi-trillion-dollar healthcare industry -- nearly 20% of the national Gross Domestic Product. The “healthcare crisis” – characterized by insufficient access, population disease burden, social determinants of health and unsustainable cost – is, then, the concern of policy makers, elected officials, health administrators and even businesspeople. Medical care, on the other hand, is where healthcare actually touches patients. It is a profession, not an industry. It is the concern of doctors and other professional caregivers.
Common sense suggests there is little use in solving the healthcare crisis in America as long as we have an overlying Medical Care Crisis. Why even seek out a financial wealth advisor if the advisor was going to be unavailable, burned out, more concerned about their own commissions than our financial goals, committed to sending only text messages for communication, allowing their administrative assistant to manage the investment funds and indifferent to communication?
If we are not going to tolerate such from our financial advisors, why, then, do we tolerate it from our medical care advisors?