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| Coming to an end? |
This series will examine a major shift underway in the hospital-physician-insurer triad. While hospitals and physicians have been closely affiliated for decades, we suggest that this historically cozy relationship may be coming to an end. What's more, we brazenly predict that health insurers (yes, insurers) and physicians will find that they have more in common, leading to a significant new alignment between these two entities.
"Hmph!" you say? "No way!" is your reaction? You think the DMCB has really gone off the deep end this time? You may be right, but check out the posts and then decide if any of it could be possible.
The first introductory post is here.
Posts
5 comments:
The first installment is tightly reasoned and nicely written but suffers from one serious omission. In this overview of what they predict are transformative changes in health care, they make no mention of patients.
This is either prescient: patients will become an irritatingly necessary by-product of the new system.
Or it means they have no credibility. None. Zero. Zilch.
We'll see.
Peter Elias, MD
Good point Peter! Thanks for the reminder. I guess the assumption has been that the doc-hospital alignment has served patients well. Will the emphasis on value - for patients - lead to an alignment between docs and insurers?
Let's see how these posts unfold.
Thanks for your feedback.
It seems pointless to consider a 100 year view with the current pace of system change. A little like mental masturbation.
Still, the dynamics surely will evolve along the lines of improving quality of healthcare systems which will make things more efficient. Hopefully for profit insurers will be extinct in 100 years.
Also a good point. We'll need to point out that the shift from a 100 year pattern doesn't necessarily mean this new stage will also last a hundred years.....
I guess the assumption has been that the doc-hospital alignment has served patients well.
That has certainly been the assumption of clinicians and hospitals but my conversations with engage patients, family members with chronic disease and serious illnesses, and my own experiences in the patient role argue otherwise.
When I assume, I make an ass of u and me.
Will the emphasis on value - for patients - lead to an alignment between docs and insurers?
I'm sorry to say, I saw no credible references to value for patients in their first post.
For me, the bottom line is that, if we want value for patients, we need to make sure we understand the job(s) that patients want done. And that means involving patients from the outset and at every level.
How would we feel about the contractor and the architect and the building supply resource who felt they could add value to the addition they are building to my home - but don't even mention me in their conversations, let alone include me?
The words arrogant, self-serving, limited horizons, and especially epistemic closure come to mine. I'm sorry if I sound harsh about this, but it is really a shame to have such significant effort from such bright and concerned folks go to waste because they start with a missing key ingredient. (Like making bread without flour?)
Peter Elias, MD
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