Saturday, June 26, 2010

The Airline Industry and Health Care

In many past speaking gigs, the Disease Management Care Blog used the airline industry as a template in thinking about where health care is going. Increasing automation (releasing the pilots to focus on what was important), shared responsibility (other highly trained professionals share the job of getting the plane in the air), consumerism (destination and safety are assumed, it's how soon that beverage cart gets to my seat that is really important) and transparent price competition (including user-friendly web sites) were all going to mean better travel (quality) at lower fares (cost).

Was the DMCB as prescient as it likes to think?

After reading the Weekend Financial Times article on how dreadful flying has become ("Flying Backwards", the DMCB still thinks so. The airline industry's emphasis on safety (fatalities per passenger-mile have dropped exponentially) and pricing (albeit with a perpetually lousy return on investment) have paid off for fliers. Unfortunately, customer service has clearly lagged.

Patient safety is not where it it needs to be but at least it's being measured: a good first step and it will get better. As for pricing, healthcare is operating under the Medicare fee schedule. This results in relative overpayment for some specialty services and underpayment for others (such as primary care). It's the underpayment in primary care that has led to crowded waiting rooms (like the back of the plane) and lousy customer service (delays? pfft!). Yet, the good news is that the primary care physicians are also looking at automation, shared responsibility and consumerism.

It all adds up to the Medical Home. The only difference is the pricing, which is not being left up to the market. Let's hope the Feds get the pricing right.


Dr Synonymous said...

As a family physician in private practice, I like your comparison of health care to the airline industry. Now Primary Care is going to get the technology and professional extenders similar to airlines. They are now being purchased by hospitals and will become overly aligned with feeding bodies into the higher paying procedure lines on hospital budgets.
Consumers have expectations of primary care physicians which will wane, just as with the airlines. Patient satisfaction has already been the victim of early Patient Centered Medical Home (PCMH) projects, so the back of the plane will still be disgruntled.

The overcrowded emergency rooms will get worse as newly insured patients will seek services that are not available in the underpopulated (only 8-9% of medical students are going PC, instead of the 30+% needed), but now technology enhanced, primary care ranks.

Hospitals are now benefiting by studying the airlines checklist procedures and hearing safety presentations by Sully Sullenberger. (as mentioned in my blog post "Captain "Sully" Sullenberger: Safety Messages from "The Miracle on the Hudson")but the CEO's are more into mergers and acquisitions than health care which, I think, aligns with DCMB prescience about airlines and health care. It's going to get worse, but will there be crashes? We will stay tuned to DCMB for the answers.

bizconnmedia said...

The past year air travel suffered at least that is what the news industry reported with body scanning, check point delays, long lines and cramped flights. The one airline that has captured my interest is Southwest Airlines. I do not even fly Southwest but their television commercials are just brilliant. The marketing of their service caring for their customers "bags" is a winner! I believe the baggage handlers truly do care about our bags and they are having great fun at the expense of all other airlines.