by Anthony Cirillo

Until you experience the healthcare system as a patient or a caregiver, you will truly never know how to fix it. A few cases in point: A year ago on Christmas Eve my mother took a tumble that fractured her neck. She ended up in the hospital for a week as a result.

Experiencing the hospital up close and personal as a concerned son, I came to realize that I could serve a much bigger role as an outsider talking about healthcare issues than as a chief marketing officer in a hospital--a position I spent many years at and would probably never do again.

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My friend and colleague Phil DuBois had a similar awakening, though it was instigated by a much more tragic event. After his wife was killed in a tragic car accident and he was gravely injured, Phil, a former nursing home administrator, became a resident in his own nursing home.

While the care was generally good, he saw so much that was missing that he felt compelled to leave his position and pursue a higher calling. He now is an in demand speaker to nursing home administrators, compelled by his story and yearning to learn the lessons he shares.

What you see from the inside is not necessarily what people see from the outside. And unless you have that perspective it is hard to change healthcare.

And then there's the experience of M. Bridget Duffy, M.D., former chief "experience" officer for the Cleveland Clinic. After this video, she was involved in a scooter accident and experienced the healthcare system as a patient.

This second video finds her sharing her experience as a patient and hints at why she's now pursuing a much bigger role of working to infuse patient experience principles in hospitals across the U.S. As a patient in her own hospital, her experiences were not always good ones.

Dr. Duffy's observations as usual are spot on. Having courageous leaders in healthcare who empower their employees was her main conclusion--something we have blogged about here. Further she talks about how the entire healthcare system is built around the delivery of technology and the audience that is wooed is specialty physicians. What is wrong with this equation? More, she says what matters most is the emotional experience of the patient. Listen to her talk about Code Lavender for the full impact.

I feel that Phil and Bridget left their respective institutions because they see from a very global and systemic viewpoint just how much needs to be done in healthcare.

And here is what causes an ache in my heart: Health reform is not going to fix any of this. In fact it will exacerbate it. As more people seek care, their experience will get worse. More people. More strain. And yet hospital marketers will continue to advertise in an attempt to attract more patients, rather than educating people about how to access and navigate the system. Compound that with reimbursement cuts and maybe you will see service cuts.

And then there's the insurers. Although they may be mandated to cover you, they may still deny your payment, as this Los Angeles Times article notes.

Promoting cost containment and price competition may actually add to the pressure on insurers to deny requests for treatment. Reform will make it more difficult for insurers to control their costs. According to the article, this "leaves insurers with the other big cost-containment tool: turning down requests to cover treatments."

Yes we need courageous leaders and as Dr. Duffy points out, they are going to have to come from the up-and-coming group of young administrators.

But we need a different bunch of carrots for our current carrot and stick approach. Until we somehow figure out how to reimburse for wellness not episodes of sickness; until we incorporate total experience into JCI standards and reimbursement (and please not just HCHAPS); until we start educating the public about their own responsibility in all this--nothing will change.

I'm stepping down from my soapbox now. It's your turn.

Anthony Cirillo, FACHE, ABC, is president of Fast Forward Consulting, which specializes in patient- and person-centered care and strategic marketing for healthcare facilities.