Re-Humanizing Healthcare
Every health care professional began their career desiring to do the right thing for their fellow man, and themselves. Shortly after entering their chosen profession most if not all are disillusioned, and frustrated as are their patients. I realized this early in my career as well, making it now some 24 years ago.
The primary purpose of this web page, and the goal of the rest of my career, is to Re-Humanize the Practice of Western Medicine. By this I intend to help steer health care reform in the direction of humanizing the professional and patient experiences.
The dialog offered within this website is open, and intended to stimulate discussion amongst all that are interested. The definition of humanization is a subject that will take many different perspectives to bring to a solid and functional reality. Once defined, re-humanization will serve as a guide for the work ahead.
Perhaps the most difficult aspect of the effort has been the redesign of the compensation models for healthcare. I recognized the need for this about a decade ago, but through additional study and discussion have come to see this as the most pressing of the opportunities. By t his I mean that healthcare professionals and systems are compensated based on the encounters (office visits) or procedures (surgeries, x-rays etc.). As a result we have a system that is very effective at generating more of what is paid for.
Unfortunately more encounters and procedures do not translate to better health in a population. In a recent study by the Institute of Medicine, a patient receives the intervention during an encounter that is supported by the best medical literature 50% of the time in a primary care visit. The risk of a procedure (surgery) for a given individual is more closely related to the number of surgeons than the demographics (age, race, gender, illness profile etc.) of the population. In the end the measures of the health of a population are not related to the investments in the medical care provided.
Our method of compensation in health care follows the basic economic principles of capitalism, you not only get what you pay for, you get more of what you pay for. Patients, providers and insurers are all victims of a compensation model that evolved as a result of a very complicated and difficult to measure outcome and an equally complicated billing system. The only way to resolve this is a true health care reform.
There are other aspects of the practice of medicine that will need to be addressed to assure a truly “humane” practice. Many of these will come as a result of a reformed compensation system, but many others will require thoughtful and capable guidance. None of these however, take precedence over the imperative of compensation reform.