I have worked in the healthcare industry for over a decade and absolutely agree with your point of view on aggressively patient-centered care (and, as you certainly know, patient centered care models improve outcomes, reduce cost, and increase pt and provider satisfaction).
One of the biggest difficulties, IMO, that our industry faces is that we have, especially on the facility side, vast overresourcing and fixed cost structure. Ultimately, most of the longitudinal models that have a strong PCP & patient focus result in decreased utilization of inpatient, ER, and specialist services (again, paired with improved outcomes and pt/provider satisfaction). How do you think we, as an industry, confront the difficult reality that overtreatment and avoidable treatment are significant sources of funding for most hospital systems? Also, in your opinion, how do we best resolve the clear overcapacity issues in some service lines (e.g. availability of advanced imaging - city of Dallas has more MRI machines than the entire country of canada).
There are clearly other inefficiencies in our healthcare delivery system (admin costs, claims processing, PLI, etc) but to me, those are outside the scope of the clinical delivery system and can be resolved through other routes (e.g., many health systems have delegated UM and no longer have to get approval from the insurance company for LOS or admits, some claims-related items are slowly starting to shift in this direction, etc).
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Hi Dr. Montori,
I have worked in the healthcare industry for over a decade and absolutely agree with your point of view on aggressively patient-centered care (and, as you certainly know, patient centered care models improve outcomes, reduce cost, and increase pt and provider satisfaction).
One of the biggest difficulties, IMO, that our industry faces is that we have, especially on the facility side, vast overresourcing and fixed cost structure. Ultimately, most of the longitudinal models that have a strong PCP & patient focus result in decreased utilization of inpatient, ER, and specialist services (again, paired with improved outcomes and pt/provider satisfaction). How do you think we, as an industry, confront the difficult reality that overtreatment and avoidable treatment are significant sources of funding for most hospital systems? Also, in your opinion, how do we best resolve the clear overcapacity issues in some service lines (e.g. availability of advanced imaging - city of Dallas has more MRI machines than the entire country of canada).
There are clearly other inefficiencies in our healthcare delivery system (admin costs, claims processing, PLI, etc) but to me, those are outside the scope of the clinical delivery system and can be resolved through other routes (e.g., many health systems have delegated UM and no longer have to get approval from the insurance company for LOS or admits, some claims-related items are slowly starting to shift in this direction, etc).
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