The 11 Monsters of Healthcare (Part 1 of 2)

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HGR-thumb1The former acting administrator of the Centers for Medicare & Medicaid Services, Don Berwick, MD, challenged 1,400 healthcare executives last week at the American Hospital Association’s Leadership Summit with 11 monsters of healthcare that are scaring hospitals around the country, Cheryl Clark reports for HealthLeaders Media.

“We’re scared of the truth, the next wave of what we have to do to transform healthcare. And it crosses some scary landscape. It’s stuff we don’t want to think about and don’t want to talk about,” he said, noting also the many improvements that have been made in patient safety.

Here are the first five monsters he covered:

First, he challenged hospitals to “instill confidence in science as a basis for action.”

Berwick was referring to the false messages the public often hears about healthcare reform and the suspicion and confusion that results from “exploitive accusations that scientific thought is elitist…a way to deny people what they need. We say science, we say evidence-based medicine, and the public hears ‘rationing.’”

Second, he urged them to “use our global brains,” referring to advice he had been given while head of CMS about never praising or evaluating the healthcare of other countries. “If you do, you’ll take a cheap, demagogic shot from someone who questions your loyalty or says you’re a socialist…”

But it’s important to remember, he said, history’s greatest medical breakthroughs have come from all corners of the globe. We need to tap into the wisdom and research that other countries have to offer.

Third, he thinks there is much to be learned from large healthcare systems. Clark summarizes Berwick’s thoughts this way: “Somehow, American healthcare’s thought leaders must learn how to improve care by experimenting with change in real-time clinical environments, not by researching or adopting what happened in the past. But they haven’t sufficiently developed, nor have they widely accepted, new investigatory approaches and they will have to get over that.”

Fourth and perhaps the scariest monster of all, he said, was excess, which is why many leaders shy away from confronting it head-on, even if we’re overspending on healthcare by 40 percent as a nation. He said, “It will take courage to name and address what I believe is a large proportion of American healthcare that just doesn’t help people, but subjects them to risk.”

Fifth, he believes healthcare leaders need to “distinguish profit versus greed.” While he praised the “energizing entrepreneurship” and “proper competition” of the American healthcare marketplace, he warned the same marketplace “has cynical, calculating greed in it. And we do not have methods in public policy or in private to tell the difference between entrepreneurship and greed and act on it.”

He then cited the impudence of many pharmaceutical companies in price-gouging both hospitals and consumers.

Tomorrow, we’ll cover the final six monsters he listed, but in the meantime, how has your hospital tried to confront these first five monsters? What have been your greatest avenues to success in these areas, no matter how miniscule? What have been your greatest obstacles to success?

-by Pete Fernbaugh

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