|
What we understand from 2000
physician interviews
The key
players in today’s healthcare delivery environment are all struggling for
control, at the expense of better patient care and to the detriment of the
physician-patient relationship. Conflicting priorities of hospitals,
payers, physicians, and government have systematically eroded the
physician-patient relationship built on trust and caring. The “business of
medicine” has replaced the “art of medicine.” Health outcomes have been
impacted adversely, as demonstrated by the recent reports by the Institute
of Medicine on patient safety and medical errors. In over 2,000 interviews
with physicians, we understand:
·
A desire for greater autonomy in their medical practice
– clinical and financial
·
Doctors are seeing more patients, working longer hours
and making less money
·
Administrative costs associated with managed care,
billing and information management have drastically increased
·
The promised solutions offered by hospital buyouts or
practice management organizations have not materialized
·
Doctors want to refocus on their patients
Many models for organizing physicians and
hospitals are failed or failing…
Under the banner of “integration,” there have been
numerous attempts to reduce healthcare costs and improve medical outcomes.
But none of the proposed solutions has correctly aligned the interests of
the many players involved in delivering healthcare. The current models of
“integrated systems” and physician practice management organizations
respond to investors and government regulation, not patients’ interests.
They are focused on reducing costs and controlling physician behavior.
Because physicians could not or would not invest in these solutions, they
became employees of the system. Where physicians do not own or direct, they
are not committed to making the models successful. The result has been for
some physicians to be treated as technicians, not owners.
When physicians
own and direct the enterprise, they have more control over healthcare
delivery, provide consumers with options which patients prefer, gain
autonomy in their medical practice, increase their fee-for-service revenue,
and can participate in the financial rewards from services they use every
day in the practice of medicine.
Physician-owned and directed healthcare delivery does
work. When we look at the most
successful healthcare delivery systems today, the common thread is
physician ownership. The Texas Orthopedic Hospital and Texas Woman’s
Hospital in Houston, TX, are two examples of specialty hospitals owned and
directed by physicians. Both of these institutions were created by
physicians who were experiencing the same frustrations facing most doctors
today.
The Mayo Clinic and Cleveland Clinic, examples of
multi-specialty clinics directed by physicians, are the “gold standard” in
clinical quality and patient-centered care. Their physician founders knew
there was a better way. They designed their system to provide comprehensive
and collaborative patient care with the consumer at the center of the care
model. The systems work and patient satisfaction is world-renowned.
The Healthcare Village:
Physician-Designed, Owned and Directed
The HealthCare Village is an innovative model of
ambulatory healthcare set in a “village” design concept that will be a
magnet for healthcare consumers in the new Millennium. The HealthCare
Village is a one-stop destination to meet families’ health needs and
lifestyle. Each HCV is custom-designed and programmed to meet the specific
needs of the community it serves. It offers a comprehensive array of
primary and secondary care, with physician-based centers of excellence and
a short-stay hospital. The HCV will also incorporate health-related retail
and allied services for its patients, including daycare, healthy kitchen,
fitness centers, and a healthcare resource for both physicians and their
patients.
The HCV short-stay “ambulatory hospital” will be
programmed and custom-designed to meet local and community needs. The services
offered will be those that can be successfully supported by the physicians
of the HCV, and the surrounding medical community. This Stark-compliant,
non-tertiary facility is modeled on successful physician-owned hospitals.
Unlike most traditional hospitals, services will be performed where they
are needed most, Imaging and laboratory services will be located on the HCV
campus, not a twenty-minute drive to the “medical center.”
Before the hospital is even built, the planning and
research process will identify who will use the hospital, what services and
procedures will be provided, what equipment will be needed, and how it will
be owned and directed. The hospital will only be built if it can provide
its physician owners with control, autonomy and return on investment.
|
