Filtering by Tag: Healthcare

2 Phrases to Never Use When Selling to Hospitals

I have seen just about every vendor pitch known to humanity.  For over 19 years, I was Executive Vice President at Georgia Hospital Association, and one of my five areas of responsibility was leading the entrepreneurial subsidiary that endorses outside vendors.  So I had a string of vendors regularly coming through my office.

 

The concept of pattern recognition teaches that, given enough data, you begin to notice certain things repeating over time.  And my 19+ years of hearing companies pitch their products definitely honed this skillset.  Most did a fine job presenting their products, but I learned to screen out potential vendor partners as soon as they uttered one of the following phrases:

 

"We're the only company that has . . . .”  The first few times I heard that, I naively believed it, but as I dug around after those meetings, I learned that most of the time, that claim was a stretch at best or a complete fable at worst.  I'm not that smart, and if I figured that out, you know that hospital leaders will also see through the fog.  Uttering those words may gain you some immediate interest, but once your sales prospect figures out that your claim is akin to stating that dark chocolate is a health food because it has a tiny amount of anti-oxidants, your credibility tanks. 

 

Unless you are truly first to market in a given niche, the chances that absolutely no one can offer what you can is pretty remote.  Technically, you may be the only vendor with a very specific approach, but there is a good chance another vendor may offer a parallel approach that substantially overlaps with yours.  Don't utter those words.  You will be ratted out!  By all means, talk about your product's superior features, but don't claim that no one else can do the same unless you can document that.

 

"All you have to do is . . . ."  I recall one vendor who came into my office and stated that he had spent eight years studying supply chain issues in the automotive industry and had just figured out how inefficient hospitals are.  Now he was applying his knowledge to solve hospitals' miserable performance.  "All you have to do is . . . . ." 

 

Sorry.  Game over.  Thanks for playing.  That phrase betrays a woeful underestimation of healthcare's complexities.  Management genius Peter Drucker famously identified healthcare as the most complex industry to manage.  With countless layers and overlaps, dozens of competing agendas, and professional rivalries of all kinds, the word "complex" may be an understatement.  So uttering, "All you have to do is . . . ." immediately pegs you as an industry outsider and implies that you think you’re smarter than the highly educated professionals who have invested years in the industry.

 

By all means, promote your product's uniquenesses, and be sure to point out how your product will streamline operations.  But don't overstate your case, and don't blow your credibility by underestimating the difficulty of retooling healthcare's processes.

 

A Possible Compromise Regarding Healthcare as a Right

One of our thorniest health policy issues is whether or not healthcare coverage is a basic human right. Those who say “yes” feel that it’s immoral to deny anyone care. Those on the other side point to the economic challenges – including likely rationing – of providing expanded care for all. In this contentious, polarized political climate, it’s unlikely that either side will convince the other any time soon. But, if I may be so bold, there may be an acceptable compromise.

Before I present my idea, let’s consider three primary drivers that brought healthcare coverage into the public’s consciousness in recent decades.

·         Charges of hospital emergency rooms “dumping” patients in the 1980s. Some highly publicized cases where hospitals allegedly dismissed uninsured patients from ERs without properly stabilizing and treating them caused understandable public outcries and played a major role in passing the Management and Treatment of Active Labor Act of 1986 (EMTALA).

·         People being denied coverage or having extraordinarily high premiums because of pre-existing medical conditions.

·         People literally being bankrupted by crushing medical bills triggered by catastrophic medical crises.

Here’s my proposal. What if we had a two-part hybrid system?  

·         Part 1 – A national public plan that provides emergency/preventive/primary care and catastrophic care for everyone. It would be backed by a combination of increased employer taxes and redeployment of some existing funding for Medicare, Medicaid and the Children’s Health Insurance Program.  

·         Part 2 – A reconfigured private insurance market that offers coverage to fill the gap between emergency/preventive/primary and catastrophic care. This supplemental insurance would be paid for either by individuals who wish to purchase it or employers who want to provide extra coverage for their employees. Additionally, state Medicaid programs could help fill the gap for Medicaid patients if they so chose.

This approach would address all three problems listed above.  It would:

·         Guarantee coverage for life-threatening situations

·         Keep pre-existing conditions from freezing people out the insurance market

·         Minimize bankruptcies caused by catastrophic medical bills.  

Even though employers’ taxes would rise, their total healthcare spend probably would not.  Their increased taxes would be offset by decreased insurance premiums since they would no longer have to pay for the emergency/preventive/primary and catastrophic care they pay for in their current policies.  

Importantly, this concept also maintains a place for private insurance companies, who are understandably dead-set against a fully socialized program that would render them irrelevant. 

The “healthcare is a right” group should be pleased that everyone has guaranteed access to basic care, and those on the other side should see this as a more affordable option than all-out, expensive full coverage for everyone.  

Some might complain that this concept would establish a two-tiered system since not everyone would have the supplemental private coverage. But I would argue that in a free society, not everyone accesses the same products and services. That’s why we have both EconoLodge and Ritz-Carlton hotels. Furthermore, our current system does not adequately care for the needs of the “have nots.” This would at least be a good step toward more equity.

Let me know what you think.

 

 

Why Would You Ever Do THAT?

One of life's great pleasures for me is grabbing my bike and pumping out 25 to 40 miles on the Silver Comet Trail, a terrific 62-mile rails-to-trail bike path that runs from the west side of Atlanta to the Alabama border.  Really serious riders put in 100 miles or more each week.  Unfortunately, my schedule doesn’t accommodate that.  Every year, though, I do try to participate in at least one organized Century (100 mile) or Metric Century (62 mile) ride where maybe 150 riders meet up to ride a designated route together. 

As in all sports, equipment factors in heavily.  And technology constantly marches forward.  About 20 years ago, carbon fiber became the material of choice for high end bicycle frames, ousting titanium, steel and aluminum.  Carbon fiber's strength, flexibility and light weight make it an ideal material.  My bike weighs about 18 pounds before you put on the pedals and some other peripherals. 

Most Century riders have similarly lightweight bikes.  So if I'm riding with my buddies, I definitely want to use the most favorable equipment to keep from being at a competitive disadvantage.

However, I could dust off my old 35-pound, single-gear Schwinn that I used in middle school that's made out of steel (or is it lead?) and try to compete with guys using bikes that literally weigh half as much.

Schwinn Bike.jpg

But why would I do that?  I wouldn't.

When it comes to patient care and coordination, many of us in healthcare are doing the equivalent of hauling out the old lead bike.   For decades, we have been complaining about the fractured nature of patient care and the fact that the right hand and the left hand might as well be on different bodies.  There are many reasons for this and why healthcare lags behind other industries. 

Probably the two biggest are cost of technology and the complexity of changing operations to tap into the new capabilities.  Caregivers are there to render care to patients, not act like technology wizards.  When you are heads-down, slogging through patient care activities day after day, trying to keep the lights on in an era of increasingly squeezed payments, it can be tough to raise your head long enough to figure out how to incorporate the emerging capabilities.

But guess what?  Technology now enables us to graduate from steel frame bikes to carbon fiber.  The Internet revolution, cloud-based storage, Software as a Service, the proliferation of smart phones and tablets, and other breakthroughs have ushered in a new age of user-friendly, mobile capabilities that support the goals of higher quality care at reduced cost.  I firmly believe that population health management, readmissions reductions and value-based purchasing are not possible without tapping into today exciting technology-supported processes which didn't exist even 10 years ago.

Yet many in our field are clinging to our old single-gear bikes when ultra lightweight 20-gear ones are sitting right in front of us. 

Why would you ever do that?

 

Faulty Comparisons?

“You’re not really going to eat that, are you?” my friend asked as our hosts left the living room.

I looked down at the luscious-looking mango and papaya and tried to ignore the dozen or so flies that were already enjoying them.   “Well, we can’t offend our hosts” I replied.  Looking over his shoulder, I could see through the open window the huge sow in the backyard, caked with mud and “sow stuff.”  It wasn’t hard to speculate on where my little fly friends had enjoyed their previous meal.

We were on a church mission construction trip about an hour outside Havana, Cuba.  On the way to our worksite that morning, piled eight people in a car built the year I was born, we had witnessed a street fight between two men with machetes.  And just before we took our break, one of our guys was clearing away a large stone and found a scorpion the size of a child’s fist.

Cuba claims very impressive population health statistics.  Not to be a skeptic, but I don’t believe them.  Between the ever-present flies, the questionable running water, crumbling and sometimes-dangerous infrastructure, and other environmental hazards, this place was a public health nightmare.  Yet critics of the U.S. health system love to tout statistics that place Cuba ahead of us in health status.

Let me be clear.  Having spent 30+ years in the hospital sector, I am as aware as anyone else of our healthcare system’s foibles.  The dysfunctionality is sometimes astounding.  Yet I am weary of people citing statistics showing how lousy our system is when some of those numbers fail to consider factors outside healthcare that may be driving down our standing.

About 25 years ago, I heard a healthcare speaker point out that non-medical social services vary tremendously from country to country, and that this may be a significant factor in superior health outcomes for certain countries.  Although I never further investigated this concept, that insight stuck with me. 

Recently, a blog by my friend Kurt Mosely of Merritt Hawkins addresses this very issue and provides some interesting stats:

·         The U.S. spends more (16.3% of GDP) on healthcare than any other country.  France, Sweden, Switzerland, Japan, and Germany each spend about 9% of GDP on healthcare.

·         The U.S. spends 9.1% of GDP on social services (food, heat, clean water, housing, job training, etc.) that help keep populations healthier.  France, Sweden, Switzerland, Japan, and Germany spend twice that amount:  about 18%.

This may point to what is referred to as the medicalization of social problems.  I am not whitewashing the limitations of the U.S. health system.  But I am disappointed that people (some of whom seem to be agenda-driven) often fail to acknowledge the multiple factors that ultimately roll up into health status statistics.  The objective of this blog is merely to provide some perspective on the United States’ relatively poorer health numbers.

When I worked at a hospital outside Detroit, we regularly welcomed patients from across the Canadian border and sometimes from more distant countries because we were able to provide the care they couldn’t get in their home countries.  My only point is that this dynamic should somehow be factored into international comparisons.