Month: October 2009

How healthcare institutions talk to you.

Found my work life’s new mission statement in this masterpiece by Jay Parkinson: “Healthcare needs to be made cool, engaging, unique, transparent, and personalized."  The reality he writes of is tremendously frustrating to those of us who know the system can be better (and are working to make it so).  His consistent pushing is appreciated.

I’ve been thinking a ton about the fact that patients aren’t the real customers in healthcare. Very little has been designed for you— the user of healthcare. When you visit a hospital’s website, do you get the same feeling as using Kayak to purchase a plane ticket or tumblr to create your first blog and start publishing within 30 seconds? Do you feel more knowledgeable or more empowered? Nope.

Healthcare talks to you in two ways. They choose from a few different stock photos of smiling old people, male doctors, and photos of their institutions. And then they have two different messages:

“We care about you.”

and/or

“We’re the best.”

Visit Hopkins, Mayo, Ronald Reagan UCLA Medical Center, Cleveland Clinic, Mass General, and the Ohio State University Medical Center.

They’ll also throw in the obligatory syndicated health information in “diseases A to Z” because they think you’ll go to your nearest hospital’s website to search for health information rather than your Google search bar.

And these are the top institutions in the country all saying and doing the same thing. Do a random search for some rural hospital somewhere in America and you’ll find the same messaging. It may be tweaked with something like “We’re the best (for Western Maryland)” but of course don’t forget “We Care about you.”

Do they think that people respond to this messaging and these uber helpful tools providing generic syndicated health information? Or is this just a symptom of ridiculously unimaginative groupthink?

The main problem lies in the fact that all of healthcare tries to do all things for all people…and their messaging reflects that generic nothingness.

Healthcare needs to be made cool, engaging, unique, transparent, and personalized. We need to drag it out of pre-Mad Men era messaging, Marketing 101, and 7th grade health class and make the experience one that’s as awesome as buying a computer from the Apple Store or a hip replacement from Bumrungrad.

I can guarantee that in the next 5 years there will be an entire healthcare ecosystem that springs up from the periphery that truly speaks to you and lives up to the same expectations you have from Apple or Kayak. It won’t come from the establishment. It will come from a network of people who simply want something better for themselves and for you.

Are you sure that was a bogey?

My dad told me when I was growing up that business people judge character based upon how one plays the game of golf.  Research isn’t needed to validate his claim but this Marketplace interview between Kai Ryssdal and Dan Ariely on cheating and golf notes the reality (emphasis added).

Dan Ariely: We do know how they did. First of all, it turns out that people in the pharmaceutical industry cheated a lot, but they also said their industry is the most honest that there is. …

Kai Ryssdal: Bring this back to the workplace for me then. What does this tell us about the way things get done in this country, and how we actually do and manage our economy?

Dan Ariely: First of all, I think cheating in golf is kind of a good example for how we think about day-to-day tasks. The fact that people can take a mulligan or how they can cheat on golf, I think tells us that’s there a lot of corner bending that we see in the business world. And what I worry about is that once we start in this path of immorality, even with small bending of rules and cutting corners here and there, that this tendency could become bigger and bigger and really a part of the collective understanding of how business is actually done.

Smoking has its benefits?

With more hospitals banning smoking (a very obvious correct decision), Michael Skapinker writes at the Financial Times on the collaboration opportunities they’re eliminating:

Companies spend money on activities such as Outward Bound adventures and cookery classes, hoping to encourage bonding between different departments. Smokers already cross those boundaries. Look at any group congregating for a cigarette: you will see senior executives and security guards, marketing and IT support.

Does smoking produce business benefits? “There’s no doubt in my mind that it inspires cross-departmental collaboration,” one FT commercial manager (and smoker) told me. “You get to know people who you otherwise wouldn’t, and get a feel for what they do. If you’ve half a spark of creativity about you you’ll doubtless stumble across an idea you hadn’t thought of before. It also allows for the ‘off the record’ conversations between departments that grease the wheels of business. I’d be pretty lost without them.”

I have seen the enemy and he is us; industry blindness

Via Dan Pink via the new book “See New Now:”

A study of the top fifty game-changing innovations over a hundred-year period showed that nearly 80 percent of those innovations were sparked by someone whose primary expertise was outside the field in which the innovation breakthrough took place.

Could it be termed “industry blindness?"  Years of experience learning "how we do things” takes a toll upon in-industry creativity.  It’s the ability to take a process concept and apply it to a problem in another field that is the crucial skill.  The study mentioned above reveals that only 20 percent of the game-changing innovations came from within the industry.

It’s really difficult to critically investigate opportunity within one’s purview when all of your experience comes from one field.  The outlook is limited by tight focus.  Health care is especially prone to this problem because the vast majority of workers in the industry are lifetime members.

So consider hiring from outside health care when you can.  Encourage reading of all things not health care.  Reciprocate visits from professionals in other industries.  We often turn to each for help in solving our problems.  Here’s to asking someone the publishing industry.

Frontlines, Part 1

Read this.

I completely agree with Dr. Jay’s sentiments.

Good luck with the surgery Jordan.

jayparkinsonmd:

jordansheartsucks:

Day one at the hospital is more or less complete. Time knows no bounds here, so I’m sure I’ll be woken up around 3 am to be asked how I’m sleeping, and then maybe be stabbed a few times for good measure.

Hospitals have a certain, unique way of making you feel like an invalid. I came here totally able bodied, and have mostly gone unscathed, but sitting here in my room, it’s hard not to feel like a victim of some terrible disease, weakened and vulnerable.

They refuse to allow you to wear the clothes you arrived in, insisting on a gown and, if you fight hard enough, sweat pants. I’ve got a cumbersome heart monitor on that rivals Flavor Flav for ridiculous sized neck pendant, and I’m hooked up to one of those medicine drip poles for blood thinner.

Moving is cumbersome, and they made me take a fucking wheelchair to get X-Rays. Even worse was when they made me sit around, waiting for someone to push me back to the elevators. I could have stood up and carried the fucking chair up the two flights of steps if they had let me.

Being around sick people, especially sick, catatonic old people, is maybe the worst part, mentally, because you can’t help but think maybe you’re just like them. It’s like staring death in the wrinkly, confused face.

As a bonus, a nurse played pin cushion with my left arm as she tried, unsuccessfully, to insert an IV, leaving a nice bruise where one might slit when life becomes all too much to handle. Might have been poetic, the crimson of my blood, the darkest I had ever seen, had it not hurt so much.

Finally, the nurse said she would go get the IV nurse, which made me wonder why someone other than the IV nurse was doing it in the first place.

My dad has been a champ, just sitting there as I stare off into space, contemplating the oncoming train about to hit me. He’s gone above and beyond with anything I’ve needed, whether it’s food or a face at which to glare angrily. I apologized in advance for inevitably being a dick, but it bears repeating.

Jordan…I don’t know you but I’m glad I do now (thanks for the intro Soup!). Most people in the blogosphere have no idea what it’s like to have a medical illness on par with yours, including me, even though I’m a doctor who’s seen a ton. Thanks for sharing. It helps us all. And good luck man. Hang in there. But do me a favor…imagine what your experience could be like if you were the actual customer footing the bill. What would you want to happen vs. what is currently happening?

Pay-What-You-Wish Health Care

Imagine for a minute, just a minute, the chaos that would ensue if health care embraced a pay-what-you-wish payment model (PWYW).  The same model pioneered in (the formerly-antiquated) music industry by the band Radiohead.  Other examples via Freakonomics: law firm, chiropractor, and taxi cab.

What would be most interesting is finding out patients’ perceived value of the services they received.  Health care is an expensive good–and will remain so even after all the waste is eliminated.  But with the majority of payments to providers coming through a mediating party and the majority of payments to the mediating party coming through employers, most people have no concept of the actual cost of care.

“I didn’t feel any better after visiting the emergency room for seven hours,” one patient might say, “here’s $10 for the coffee I drank in the waiting room.”

Or, “Geez Doc, you came in for six minutes and didn’t even touch me during the exam.  Here’s a twenty.”

No more $900 for an MRI, “Thanks for the picture of my knee, $125 should cover that right?  What’s a reading fee?”

A five-day inpatient stay complete with surgery, imaging, and drugs: “$1865.47?”

There would be fewer complaints about Medicare reimbursement.