Too Many Moving Parts

We would like to introduce our newest Healthcare blogger, Dr. Kerry Willis.  Dr. Willis is a practicing family physician in Beaufort, NC, where he founded East Carteret Family Medicine. He currently serves as Chairman and CEO of the largest and oldest self-sustaining physician-led network in NC, The Beacon Company, and Chief Operating Officer of Atlantic Integrated Health (AIH). A true believer in the need for healthcare reform, Dr. Willis believes that the best solutions will be community-based and provider-directed and are aimed at improving the affordability and accessibility of medical care by reforming the healthcare delivery. The need to consider new models that are patient-centered and eliminate many of the moving parts that cause waste are the driving goal for Dr. Willis and his organization.

Kerry Willis, MD, www.aihinc.com

I look at our government and realize there are too many moving parts to fix when there are problems. For several years I have wondered why we tolerate a tax code that includes enough words to fill up a large room with its volumes. I have considered the irony of a tax code that forces me to pay someone to tell me how much I owe the government and realized that our system has gotten way too complicated. Is it any wonder that healthcare has the same problems? We have too many moving parts and every solution is a brazintine collection of new programs and rules designed to replace the last mistake that was made by our government. If I express that I have little faith that the current experiments will provide improvement in a system that expends large amounts of money to provide care, would you call me cynical?

Recently I became enamored with the idea of examining the costs of our current system. I found that we spend billions of dollars to train people to become physicians like me. I also found that on average I spend 25% of my time on tasks that have nothing to do with taking care of patients that are usually related to the pipedreams of a somewhere MBA. He believes he needs more data or has convinced someone that his plan to control my behavior would result in a savings in healthcare expense. Funny thing, I’m smart enough to get into medical school but can easily be manipulated by a clerk with a 6-week training course in prior approvals. Healthcare is in need of proven models and the end of grand experiments. Healthcare needs a close examination of the costs and motivations for care to be provided.

We do have proven models that have demonstrated a cost savings while increasing the quality of care provided. It’s called the Patient Centered Medical Home (PCMH). We can reward practices for moving to this model and save money and improve the quality at the same time. We have trials and data and savings demonstrated everywhere the model has been tried. It’s portable, accessible and easy to understand and implement. And it’s being ignored in favor of ACOs where we have no data and no savings and no one is quite sure what they are or how they work. Why because the powers that are CMS didn’t think of PCMH.

Healthcare is in need of a dramatic simplification. We have too much expense tied up in claims processing and administrative tasks to properly restructure the system. The over-reliance on claims processing and large insurance systems/companies along with a lack of leadership for fixing the problems that exist have brought us to this place. Happily abandoning claims expense in favor of quality reporting from PCMH and leadership that demands real solutions to actually fix abuses of these system will lead us out of this place. All that is needed is the resolve to change.

Comments

[Jonena Relth]

Excellent post with well thought-out suggestions. What comes to mind is what we teach in training: KISS (Keep it simple stupid). It refers to training graphics so people can easily grasp concepts. It's worked since the military came up with the idea MANY eons ago.

So I'll pose this question: Do you think lawyers and the US gov't keep things complicated so the average American has no idea what is going on and thus we are dependent on their "experts" to guide our lives? Just thinking out loud...

[Practice Management Software]

We have embraced an economic system in which he/she who holds the purse-strings, holds the power. At this point in time that's NOT the person who spent years at med school developing the expertise, nor is it the person delivering healthcare at the point of contact. All facets of health care lies subservient at the altar of profits. We beyond the point where any individual can singly do something about it. The inevitable endgame will ensue ... something must break.

[Kerry Willis]

I think you point out a fundamental problem with heathcare. Docotrs have advocated the leadership role they should have maintained for the best interest of their patients and practices to politics and the status quo...We need for that to change.