I’ve been talking about this for quite some time now - how physicians need to come out of their silos and view their jobs as the leaders of a team, as coaches, as guides, as mentors for each one of their patients.
In my talks, I mention how physicians spend only, on average, about 32 minutes with you per year (4 visits x 8 min each) for 77 years of your life = 0.0000456% of your life is spent with your doctor. We live the other 525,928 minutes per year in our respective silos.
And you and your therapist get an hour a week.
How many projects do you have going on in your everyday jobs? How hard is it to manage your team and get everyone on the same page? How hard is it to successfully pull your strategy off? Could you imagine doing your job with a team you get to see for only 32 minutes a year (when, in fact, only one member of your team actually shows up)?
Physicians have 2000 patient “projects” and are cut off from communicating with their team that most likely doesn’t exist.
The tools we’re using as physicians are outdated and inefficient. The exam room is a horrible, ancient tool that needs an upgrade. Physicians need to, first, admit that bad behavior is the number one threat to modern health. And, second, admit they’re horrible at getting people to change their behavior. Aside from psychiatrists, we simply weren’t trained well on behavioral modification. Nor do we have the time or the tools besides mind-numbing drugs and an exam room. And third, admit the chronic disease drugs we’re dispensing do very little for the diseases that are offset more by the damage done through unhealthy behavior.
Therefore, the future physician needs to serve as the executive of your health with three main duties:
Treat serious acute conditions
Create goals for you and strategies to help you reach those goals (the CEO of your health)
Build a team, decide strategy, and delineate duty to those who can execute the strategy.
Just as a CEO has his/her team of people that execute on a company’s strategy, physicians need this team of nurses, social workers, therapists, nutritionists, physical trainers, behavioral modification specialists, etc. to help you accomplish your yearly goals.
Unfortunately, the infrastructure to allow this sort of efficient delineation of duty and requisite communication to make this happen simply doesn’t exist in our health care system.
Communication is broken in health care. We’re all practicing in silos tied together by paper and a ridiculously inefficient communication technology invented over a hundred years ago - the telephone.
The internet has come along and has started to solve the problem of one-to-one, one-to-many, and many-to-many communication. It started with email and has evolved to Facebook.
Can you imagine trying to get your work done with your team without the internet and without basic email?
Our profession is, at its core, fundamentally flawed relative to how today’s world communicates and functions.
This simply can’t and won’t happen. It is absolutely unsustainable for our nation.
Health management by insurance companies has failed miserably and will continue to fail miserably until their revenues decrease and their profits dry up. The sooner we can eliminate the bureaucracy they built to tell us they’re doing something to justify their revenues, the better.
But fundamental changes in the structure of our health care system absolutely need to happen. And I’m talking about widespread change in the core processes of health care. We need to take lessons from Toyota and their devotion to process analysis and restructuring to eliminate the inefficiencies. We need to create resources for health care deliverers, an online website where efficiencies are shared amongst everyone to help streamline care delivery and cut out the fluff that consumes valuable resources. And this needs to be a wiki.
The communication infrastructure of health care needs a total repair from the ground up.
It needs to be facebooked, wikied, kayaked, and toyotaed.