The following is my dialogue with Jeff Gruen, MD (currently a Principal in the PricewaterhouseCoopers US Healthcare Strategy practice) on the question of whether there is a need for Revolutionizing Healthcare*
Abraham Lincoln famously said: “This country, with its institutions, belongs to the people who inhabit it. Whenever they shall grow weary of the existing government, they can exercise their constitutional rights of amending it, or exercise their revolutionary right to overthrow it.”
The very fact that we are discussing the latter rather than the former “right” indicates the desperate state that some aspects of healthcare finds itself in.
Prior to taking up arms for revolutionizing healthcare it is essential to emphasise the need for “revolutionizing the person”. Let us go back to 1968 and to the scene of another revolution. Reportedly, during the French student revolt of May 1968 there was a poignant graffiti which read, “The revolution must take place in men before it can be manifest in things.” In the long term it would be futile to propose solutions knowing full well that the “soldiers” responsible for delivering it may lack the humanity and humility that could make the most bitter pill taste as sweet as honey. I believe it was Mother Teresa who said: “The biggest disease today is not leprosy or tuberculosis, but rather the feeling of being unwanted.” The psychology of the interaction between the physician and the patient can be as important if not more important than the clinical care that the patient receives.
Yes, education (not only for the healthcare professionals but also the general public) is one of the main foundation blocks of an ideal healthcare system. Back in 2002 while looking at some diabetes statistics I was shocked to find out that of the 17 million Americans affected by diabetes one in three did not even know it. It transpired that even those who were aware of their condition were not receiving proper care - for example 52% reported that their healthcare provider NEVER discussed lowering blood pressure or lowering cholesterol (45%).
But it would be a mistake to prepare a highly trained and educated group of revolutionaries for a journey without ensuring that proper infrastructure, systems and vehicles are put at their disposal. There is no point in sending the most highly trained deep sea divers to the Sahara desert. Show them the Ocean…
“Nothing is particularly hard if you divide it into small jobs” – Henry Ford. The significant healthcare problems we are faced with are solvable. Furthermore, in my humble view, we currently have more technology than we need to address the issue. We are beginning to see what I refer to as Tribal Revolutionary Leaders. Leaders concentrating on specific aspects of healthcare. The trick now is to evolve this so that we can encompass all the relevant aspects of healthcare. In a strange way it looks as if the answer lies partly in revolution and partly in evolution. This echoes Robert Frost’s telling poem (see Jeff Gruen’s article above).
In conclusion, the problems associated with healthcare are not specific to the U.S. This is an issue with true international dimensions. And right here lies a most interesting opportunity. A truly international business opportunity with the potential of enviable return to the investors and delivery of a cost-effective patient-centred, caring, quality healthcare made possible mainly through economies of scale and innovative solutions, technologies and business models of a nature not available until recently.
Jeff Gruen started his fascinating and thought provoking column by quoting Einstein. It would only be appropriate to end by quoting this genius once again: “In the middle of difficulty lies opportunity”.
* Cached version available from the archives of Centre for Connected Health here: http://goo.gl/VItw1