Bo Knows Football, But Seth Knows Health Care

Remember the Nike ad that proudly proclaimed that “Bo Knows Football”? Well, after reading Seth Godin’s post yesterday entitled “Denying Facts You Don’t Like”, I would suggest that “Seth Knows Health Care”.

That may not be his realm, nor specifically the context of the post as such, but he’s got it pegged nonetheless.

Godin noted that “once we start denying facts, it's difficult to know when to stop”. That tends to be the status quo in health care today. Of course, there is a fine line between “denying facts” and straight out-and-out agenda-peddling, but I digress.

With that said, this issue has a tremendous negative impact on a patient’s health care.

Godin states in his post -

“Tell us where we are, tell us where we're going. But if you can't be clear about one, it's hard to buy into the other.”

Let’s try to be clear about where we are. Here are just a smattering of facts in health care that we don’t like, and the logical fallacies being used to rationalize the denial:

1. The health care system is #37 in the world. These are the facts according to the World Health Organization (WHO). The typical response? “Oh what does the WHO know anyways? We have the best health care system in the world”. Really?

2. The gatekeeper model is a legalized monopoly. Patient access is controlled by a gatekeeper, and a free and open market certainly doesn’t exist. The typical response? “We need to be the gatekeepers because of [insert here: patient safety, economics, etc.]”. These talking points have been soundly refuted time and time again.

3. Scientific research is ignored by much of the medical community. Take a look at the comparative effectiveness research that is currently available. The typical response? “Comparative effectiveness research doesn’t account for the ‘art’ of medicine”. No, but if you build the foundation of the house on quicksand, it really doesn’t matter what color the walls are. Or, you might hear the legendary “well, it works for my patients”. There is a difference between “it works” and “it is placebo”. As W. Edwards Deming once said, “in God we trust, all others bring data”.

4. Special interest groups define the health care landscape, not the patient. A quick review of campaign contributions ought to solve this one. The typical response? “We [insert professional association or other special interest group here] need to put more money into our legislative efforts to keep up”. Legislative accountability? I thought they were representing constituents?

5. The emergency room is the most expensive solution to the problem. There are better ways to address medical issues, especially chronic medical conditions. The typical response? Mitt Romney recently noted in an interview with CBS -

“Well, we do provide care for people who don’t have insurance, people — we — if someone has a heart attack, they don’t sit in their apartment and die. We pick them up in an ambulance, and take them to the hospital, and give them care.

This mentality simply cannot be the first option for a system of health to be successful.

6. Health care isn’t about health anymore.  The system is not built on health – it is built on illness. The typical response? “We really want to emphasize preventative care but can’t because of [insert reasons including reimbursement, etc]”. Baloney. The mechanisms underlying chronic medical conditions are well-known, but the programs (and outcomes to promote payment) are lacking.

7. The way to make a living as a [insert clinician here] is to perform more procedures. Simple. The incentives are built so that he who does the most procedures makes the most money. The typical response? “We are getting reimbursed so little now that … [insert doomsday theory here]”. Accountability to the patient – and their outcome - is nowhere to be found in a payment structure.

And the list goes on.

The current health care system routinely has data and research that is simply ignored - blatantly, unapologetically ignored for the benefit of an agenda that typically has little to do with the patient.

Fortunately, Godin also presents us with the foundation for a solution:

“Transformational leaders don't start by denying the world around them. Instead, they describe a future they'd like to create instead.”

Seth Godin may not be a primary cog in the health care juggernaut. But Seth Knows Health Care.

Photo credits: einalem