For several years I have been writing about hyper competitive markets and the impact the intense competition for patients, physicians, and skilled workers has on leadership.
Now there is a new term being floated by a growing band of outspoken leaders and patient advocates concerned with the state of US healthcare — hyper accountability. Our costs are too high and our quality of care and patient safety, two important measures of how we are performing, continue to be a problem despite the industry spend of hundreds of millions of dollars to reverse these troublesome trends. There seems to be an undercurrent within the industry that these issues are just part of the cost of being in the business of healthcare.
Last year, in a speech to more than 350 healthcare leaders, that is precisely the reception I received — they were polite, they seemed to enjoy the talk, and said so afterward, but then they moved on. This is a fairly typical response, I am told by those who have far more experience in this field than I.
Why do we appear to be so numb to this very serious problem?
We put more effort into meeting financial targets than making meaningful inroads to improve quality and reduce the shocking number of preventable deaths that occur each year in hospitals across this country.
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Hospital CEOs and senior leaders are fired all the time for missing their financial numbers, said a long-time friend who has run major hospitals and is now teaching and consulting. Being fired for missing your quality or patient safety targets — that is to say delivering care that is substandard or outright dangerous — is very rare, especially in the investor-owned hospital world.
“There is no resounding industry outrage over this very serious issue,” said a patient advocate who has been “harping about this for years. I know this sounds harsh, but I sometimes wonder if what we are really saying is, let’s pretend this didn’t happen.”
© 2019 John Gregory Self