24 Jan Buying Healthcare

Over the past decade I have had the privilege of working on the industry side in medicine.

I have learned a lot about the overall sale process.

When I was an administrator making decisions about capital equipment I had a process. I’d work closely with the physicians and physicists. I’d be responsible for the return on investment (ROI) and making the internal business case based on the clinical preference(s) of our clinicians.

I don’t believe there was ever a business case I couldn’t justify that was the preference of the physicians.

Over the past few years I’ve noticed something interesting.

The technology my company was offering would often be the preference and choice of the physicians. The physicians would make the clinical decision and share with their management team. The sales team would do their due diligence with the IT, Biomed, Finance, and Supply Chain.

We essentially were “awarded” the business.

Then things would get interesting.

The incumbent (who often may have the share of the market) would find out about the decision. Like all good sales companies, they’d make a counter offer.

The counter offer would often mean a discount on the current system, a cost savings on the service contract across multiple systems within the hospital network, and at times a discount on additional accessories.

Essentially throwing in things that seem to be of “value” or “free” based on how it’s presented.

This type of offer would go directly to the “C-Suite.” More often than not, it goes to the Chief Financial Officer. A decision is made based on the perceived value. The decision made by the “C-Suite” overturning the clinical decision of the physicians.

This scenario is becoming more the norm than it is a rarity.

It’s unnerving to me.

I’m not unnerved due to losing a sale for my company. That’s life. That’s part of the industry.

The reason I’m unnerved by the above type of “loss” is because it demonstrates that medicine is being sold out.

Our physicians are being sold out. Our clinicians. The people on the front lines of care that have made personal sacrifices in order to have the privilege of practicing the art of medicine.

Their expertise, their practical knowledge, their professional opinions are being diminished.

They’re being overruled and sold out to the “highest discount” discount. Sold out to the cheapest bidder.

Medicine is being sold out.

Its replacement?

A semi quasi business that we call healthcare.

Healthcare…a business that continues making decisions based on cheapest, fastest, more productive, and vanity metrics.

Healthcare…a business that is running a race to the bottom.

The problem is that healthcare may just win. If healthcare wins, who loses?

Medicine.

That’s right, medicine.

Physicians lose because it means more check boxes, more production, less patient face time, less autonomy, and more burnout.

Worse, it means the people in our community, and the patients they may become, lose.

Yes, I said it.

If healthcare wins, patients lose.

Patients don’t want to be standardized. Patients don’t want to be treated based on people that are similar to them. Patients aren’t all created equal, let alone are all average.

Patients want to be treated as who they are today, how their life events have defined their journey, and where they want to be tomorrow.

Patients want to be listened and understood. Patients desire to have transparent conversations to establish their expectations of care. Patients want guidance in transitioning along their journey in medicine. Patients want to be able to trust. To trust their physician(s) and their medical organization.

That’s the problem.

Healthcare is transforming the art of medicine into a business.

A business that mass produces average care for average people. (Not an average cost)

Do more, with less, be cheaper, follow the rules, standardize care pathways, fill in the check boxes, measure it, identify the outliers, black belt to fix the outlier, be lean, and continually improve the process.

Here’s the punchline……

The focus on “cost out” and “process improvement” hasn’t improved anything for physicians and patients.

When you add in the “savings” of industry market leaders buying the business of healthcare organizations, it still hasn’t made anything more affordable.

It hasn’t delivered improved outcomes. It hasn’t increased access. It’s hasn’t decreased costs.

Instead of allowing the business of healthcare to be bought, it’s time we unite as one, patients and physicians, and take back medicine.

Take back our leverage. Take back our art. Take back medicine.

How do we do that?

We do it, as we do all things in medicine, we make a decision to assert our leverage at the N of 1.

As always feel free to email me at cancergeek@gmail.com or follow me on Twitter and Instagram as CancerGeek

~Cancergeek