Pit Crew vs. Cowboys
I was prompted to answer a very interesting and particularly applicable question to a scenario I might face after college; as CEO (or senior manager) how would you propose to cut healthcare costs at your facility? This question was asked in my policy class and we were provided with three different scenarios ultimately getting at “would you cut costs here and why?” This got me thinking about what I truly would do in a situation like this. With the way our health system is right now, the costs for physicians and their services are astronomically high and it is inevitable that I will be faced with a question like this of some sorts if I end up in a managerial position.
Atul Gawande, a Harvard surgeon and author of Being Mortal, has a very interesting take on how a successful healthcare organization should be run in order to provide excellent patient care at the most affordable prices. In his Ted Talks “How do we heal medicine?” he describes this pit crew scenario. Gawande focuses on how we have so many specialized doctors, even our primary care practitioners are specialized, that instead of having say maybe two full time general practice physicians to one patient (like we were able to have years ago), we now require approximately 15 professionals per patient. These professionals range from physicians themselves, nurses, physical therapist, anesthesiologist, etc. that all work on little pieces of the patient's problem. This in itself, this broken system of how we practice healthcare in the states, is where we lose so much money. Gawande talks about bringing these pieces together, sacrificing some of the physician's own autonomy to work as a pit crew with other doctors to solve the problem at hand and not as a single entity (or what he refers to as the “cowboy”).
By operating as the pit crew, these physicians are not just working as one to help solve their patient’s ailments, but they would ultimately be lowering the cost to the individuals receiving this care. This collaboration would help reduce the unnecessary care that is usually costlier, and work towards providing only the best, most affordable, and importantly necessary care for the patient.
So, when thinking about cutting costs, I suppose the first thing I should think of is not what has to give in the organization (jobs, services etc.) so that we can cut back, but how are my physicians performing? How are they working together? Where are the gaps in care and how do I go about fixing it. None of these are simple questions to answer and if I honestly knew the exact answer on how to fix this problem perfectly, I probably wouldn’t be just a junior HMP student. The point is, this philosophy of pit crews and working as a team is really on to something major here. Working as a divided group of providers is what creates this healthcare system we currently have, which really isn’t a system at all. If managers can find a way to start even the basic implementation of getting providers to work in a collaborative effort, then we can begin to move in the right direction of cutting costs and providing those we serve with the best care we possibly can.
How do we heal medicine?
Atul Gawande, a Harvard surgeon and author of Being Mortal, has a very interesting take on how a successful healthcare organization should be run in order to provide excellent patient care at the most affordable prices. In his Ted Talks “How do we heal medicine?” he describes this pit crew scenario. Gawande focuses on how we have so many specialized doctors, even our primary care practitioners are specialized, that instead of having say maybe two full time general practice physicians to one patient (like we were able to have years ago), we now require approximately 15 professionals per patient. These professionals range from physicians themselves, nurses, physical therapist, anesthesiologist, etc. that all work on little pieces of the patient's problem. This in itself, this broken system of how we practice healthcare in the states, is where we lose so much money. Gawande talks about bringing these pieces together, sacrificing some of the physician's own autonomy to work as a pit crew with other doctors to solve the problem at hand and not as a single entity (or what he refers to as the “cowboy”).
By operating as the pit crew, these physicians are not just working as one to help solve their patient’s ailments, but they would ultimately be lowering the cost to the individuals receiving this care. This collaboration would help reduce the unnecessary care that is usually costlier, and work towards providing only the best, most affordable, and importantly necessary care for the patient.
So, when thinking about cutting costs, I suppose the first thing I should think of is not what has to give in the organization (jobs, services etc.) so that we can cut back, but how are my physicians performing? How are they working together? Where are the gaps in care and how do I go about fixing it. None of these are simple questions to answer and if I honestly knew the exact answer on how to fix this problem perfectly, I probably wouldn’t be just a junior HMP student. The point is, this philosophy of pit crews and working as a team is really on to something major here. Working as a divided group of providers is what creates this healthcare system we currently have, which really isn’t a system at all. If managers can find a way to start even the basic implementation of getting providers to work in a collaborative effort, then we can begin to move in the right direction of cutting costs and providing those we serve with the best care we possibly can.
How do we heal medicine?
Some people just have an unfair share of talent. Gawande is one of them. ;)
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