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by Lynn McVey
Six months ago, when my dad needed an emergency pacemaker, I wrote about the lack of care coordination I witnessed as an insider. Because I am an insider, I was able to navigate him through three hospitals for three life-saving interventions in three days. As the acting CEO of a hospital, I intercepted two preventable medical errors on my father's behalf. Nearly 30 caregivers walked into his room every evening/night.
At this point, we (the healthcare industry) aren't even close to solving this dilemma. We haven't even come up with a concept to link all these interventions to prevent redundancies and errors. I read today that the most likely disrupter, who might fix our current healthcare system, will probably come from a different industry. Who is healthcare's Steve Jobs or Jeff Bezos?
In a prior blog, I asked what our obligation to role model healthier living is in our respective health systems. Not a right or wrong answer, just a philosophical approach.
This week, an 89-year-old women and the sister of a 10 year old who is currently going through cancer treatment approached me. They were surprised we do not focus more on nutrition across our nation's healthcare system. We think it is wide known "food is medicine;" however when it comes down to it, they felt hospitals and care providers focused more on pills and diagnostic testing than food's impact on their health.
I have an upcoming meeting with some of our key managers and physicians to focus on--you guessed it-- nutrition. As a management team, we want to know how we could help practice with nutrition education. Some challenges include their time constraints, our payment system and the provider and patients' interest in learning more. One physician shared with me that he would love to focus more on nutrition and has many patients who simply just want the quick fix--a pill. After all, that's what we have essentially taught society: There is a pill for everything. And while the pendulum seems to be slowly swinging back, we have a long ways to go towards a balanced nutrition discussion and integration.
We've had many remarkable leaders in American healthcare, but, on average, we still get unremarkable results. The answer is simple (but not easy): Leadership needs to be less about charisma and style, and more about creating managerial systems--what I call operating systems--that standardize excellence. The stakes couldn't be higher. We must produce higher-quality, better-integrated care at a lower cost.
Successful sports teams get systems. Phil Jackson, now the president of the New York Knicks, won multiple championships with the triangle offense borrowed from Tex Winter (his assistant coach). For Jackson, the system and the supporting culture were the keys. When asked about the possible departure of one of his best players, Jackson told the New York Times: "Just deal with what is and move forward." How can he be so calm? It's because his system isn't about any single individual.
I was in theDistrict of Columbia in April, and at a meeting the idle chitchat turned to a lively conversation about Uber. Ever heard of it? I hadn't.
Uber, through the Uber App, seamlessly connects riders to drivers. At its basic level, it is a cross between taxi and car service. Founded in 2009, it is in 70 cities today. And taxi companies are not too happy.
See, Uber takes the yucky out of the taxi experience and then enhances that experience with the mobile app. I was in New York City for my birthday. Having downloaded the app, I said to my wife, "Let's try this." All I can say is, "Wow."
The narrow 5-4 Supreme Court decision of Burwell v. Hobby Lobby is a significant event. Five Supreme Court justices (in an opinion written by Justice Samuel Alito) sided with closely held corporations (a corporation where five or fewer shareholders own at least 50 percent of the company). The ruling gave them the legal right to opt out of the Patient Protection and Affordable Care Act's mandate to provide coverage for birth control assistance to employees on the basis of religious objection.
This is a significant decision as it is the first time that the high court has provided this right to nonreligious for profit entities. Up until this point, religious affiliated organizations or churches were exempt from providing care that violated religious values and beliefs; small employers with less than 50 employees were exempt from providing healthcare insurance at all.
Why is this decision so important? As emphasized by the minority opinion written by Justice Ruth Bader Ginsburg, there are thousands of closely held corporations in the United States: In-N-Out Burger and Forever 21 that could opt out of many laws for religious objections and the Supreme Court offers no guidance as to the limits covered.
In addition, there is an access issue for millions of women who rely on healthcare coverage to pay the average cost of $45 for emergency contraception (which 20 percent of pharmacies do not offer according to the New York Times) or of $1,000 for an IUD. This is contrary to the Institute of Medicine report last year that supported the Affordable Care Act's mandate for preventative healthcare services including "a fuller range of contraceptive education, counseling, methods, and services so that women can better avoid unwanted pregnancies and space their pregnancies to promote optimal birth outcomes."
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