Not enough slack

What scares me about today’s healthcare push toward efficiency is that organizations can mistake cost cutting with efficiency gaining. Finding efficiencies takes people with workloads less than 120 percent. Efficiencies are not (always) attained through fewer employees.

Yes, coming off the hangover of cost-based reimbursement organizations had to “rightsize” their workforces. And, yes, the largest expense line item on the income statement is labor.

But I feel the efficiencies through workforce slimming have largely been attained. Today’s cost conscious organizations are often left with no choice but to stack duties on already overtaxed employees. There may be no other option, but I think it’s important to understand what the organization is potentially losing through the use of this method.

All that to highlight this article from the Wall Street Journal by JC Spender and Bruce Strong:

Most great ideas for enhancing corporate growth and profits aren’t discovered in the lab late at night, or in the isolation of the executive suite. They come from the people who daily fight the company’s battles, who serve the customers, explore new markets and fend off the competition.

In other words, the employees.

Slack is needed in order to get out of the to-do list mindset. When focused completely on task after task, there’s little time left to innovate, process improve, and creatively explore efficiency finding. Sure there’s some hyperbole here, but I think the issue of a task-obsessed workforce is real.

It’s only a recommendation

WSJ Health Blog:

More than a quarter of Americans who take prescription drugs have skipped doses, split pills or cut other corners to save money in the last year, according to a new study by Consumer Reports.

When a patient leaves a physician’s office or is discharged from a hospital, they leave with what is essentially a recommendation for the continuation of care. It might be a prescription, or behavior change, or therapy, or a follow-up appointment, among many other possibilities. But the important part here is that they leave with a recommendation, albeit a strong one.

For a variety of reasons (money being only one) patients choose to either follow those recommendations or not. Not following the doctor’s orders usually means adverse outcomes. A major failing of the healthcare system (and a giant opportunity) is the lack of assistance these systems’ provide in helping patients implement those recommendations.

There is certainly work being done in this arena. And there is certainly more that could be done.

The End of Management” (Wall Street Journal):

In recent years, however, most of the greatest management stories have been not triumphs of the corporation, but triumphs overthe corporation. General Electric’s Jack Welch may have been the last of the great corporate builders. But even Mr. Welch was famous for waging war on bureaucracy. Other management icons of recent decades earned their reputations by attacking entrenched corporate cultures, bypassing corporate hierarchies, undermining corporate structures, and otherwise using the tactics of revolution in a desperate effort to make the elephants dance. The best corporate managers have become, in a sense, enemies of the corporation.

Healthcare costs less today than it did yesterday

The NY Times Economix Blog comments on a healthcare cost rarity. Here’s the rundown by sentence:

For the first time in 35 years, the one sector of the economy always guaranteed to get more expensive suddenly became a bit cheaper in July.


The medical care index [in a Labor Department report], however, fell 0.1 percent in July, after three and a half decades of constant increases.


In the last 40 years, the Labor Department reports that there are only three months in which medical care prices fell.


 So, in the last 63 years, this has happened exactly six times.

Big Think adds:

In fact, not only have medical care prices been increasing continuously for the last 35 years, but they have increased almost twice as fast as consumer prices overall since the mid-1980s.

And adds:

Although the price of drugs and medical equipment fell in July, the drop in medical prices was mostly driven by a fall in the cost of hospital care.

And adds (astonishingly):

The price of hospital care had been growing faster than any other component of medical prices—far faster than consumer prices in general—to the point that it’s now an incredible six times more expensive than it was in the 1980s.

Of course, the percentage drop falls within the margin of error. And this is only a single data point. But still. Taken in concert with the WSJ’s report on Americans consuming fewer healthcare resources, it’s a data point worth pondering.

Health is a Platform

There are major changes happening in the United States healthcare system. Some have rightly described the way we currently provide healthcare services as “sickness care.” But these changes will require traditional healthcare providers to rethink the “sickness” approach. I believe the way to do that is to conceptualize health as a platform. Read about it here.

Recognizing health as a platform transitions healthcare to a new paradigm: creating health; it flips the approach from reactive to proactive. Healthcare doesn’t have to be just about fixing what ails you, it can also help you improve what isn’t.

Helping patients feel better means the traditional healthcare organization expands its focus beyond treating illness. It finds opportunities to help patients before illness occurs and supports patients after an intervention has occurred. Recognizing health as a platform does not diminish the importance of modern medicine. It’s about incorporating the totality of health-creating elements into service offerings. The recognition provides the proper context for a healthcare organization to expand and design health-creating services for everyone.

The decision to be healthy is one that must be made by patients. But judging by the most popular New Year’s resolutions, it is a decision that many struggle to realize. Here lies the opportunity: people need help finding a deeper connection to their health. The reorganization of the healthcare business model provides a unique opportunity for healthcare organizations to lead an effort to aid patients in healthy decision-making and redefine how we conceptualize health. It’s obvious that people need to be healthier and healthcare has the ability to lead the effort.

Don’t [sic] people

Rob Walker is sorry. He made a mistake in his NY Times Consumed column. It’s in this quote:

You don’t necessary need old antique books, just books with pages with a yellow tint.

I didn’t even notice until he wrote to take another look; the quotation uses necessary when the author clearly meant to use necessarily. Both the writer and the editor missed it.

He is why he is sorry:

It happens that I have strong feelings about the use of [sic]. Hackish writers deploy this routinely to make whoever they are quoting look stupid. It’s a very cheap move, and a sure sign, in my view, of third-tier writing. It’s acceptable to use [sic] if there’s no way around it, and it’s sometimes excusable to use it if you’re trying to underscore the sloppiness, or stupidity, or whatever, of some powerful figure — if the president of an Ivy League school made a glaring mistake in some official context, maybe that would get a pass. But in general, [sic] is a cheap move — we all make mistakes, typos, little glitches, that mean nothing. This web site is full of such errors — for all I know this post will contain such errors, because I’m writing it quickly, and I don’t have a proofreader, etc. In other words, I’m no different than the person I quoted making some workaday, meaningless error.

His solution would have been to paraphrase the error out of the quotation. This mea culpa of sorts is a lesson worth learning: make other people look good even when they make mistakes. Sure there are times when you can’t get around someone else’s error; but when you can and you don’t, that’s a cheap move.