FROM TOM PETERS

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dispatches from the new world of work

TP's Healthcare Twenty-seven/December 2005

In preparation for a healthcare client conference call, I hastily jotted down this list of my more or less "beliefs" about healthcare (no particular order, not in order of importance—but main points are BOLD):

1. Fully utilize Physician's Assistants to do routine work in a timely fashion. ("Doc in a Kiosk" at Wal*Mart is great!)
2. Maximize Outpatient Services!
3. Short hospital stays work!
4. Support home care to the max. (E.g., "Declaration of Independents"—Beacon Hill/Boston)
5. STOP THE 100K+ NEEDLESS DEATHS—much/most of the "quality stuff" is eminently fixable. (Don Berwick for President! AHA for Hall of Shame!) (Strong, vicious insurer incentives!!!)
6. FLIP HC 177 DEGREES TO EMPHASIZE PREVENTION & WELLNESS. ("Steps" are being taken but not enough. Med schools: Awful! Insurers: Little better. Support for appropriate-proven alternative therapies is an important part.) (HUGE INCENTIVES FOR EFFECTIVE WELLNESS-PREVENTION PROGRAMS-MEASURABLE SUCCESSES.)
7. "Boomers" will determine HC's (very different?) future. (They are from a different & demanding planet compared to yesterday's Oldsters.)
8. "Focus on Women." (It's my generic—and correct—rallying cry, and it applies to HC in spades, women-as-patients-with different-woes-than-men; women-as-HC decision makers at the "consumer"—and commercial—level.)
9. "Patient/Consumer-driven" may be a buzz phrase bandied about all to easily ... but it is true. (And changes the game.)
10. Reduce incentives for unnecessary tests. (Malpractice caps would help, though the issue is complex. Insurers-HMOs doing so-so on this.)
11. OUTCOME-BASED MEDICINE IS A MUST! (There is a long, long way to go!) (Measure until you're blue in the face!)
12. Science-based medicine is a terrific idea!! (Many-most "therapies" unproven scientifically, uneven in application when proven.)
13. Over the next 5-25 years, the Life Sciences Revolution will make the likes of the "info revolution" look like small beer. (Get ready.)
14. Radical increase in "best practices" utilization—inculcate in Med school!
15. Med school "revolution" imperative—outcome-based medicine, abiding emphasis on Wellness & Prevention, etc.
16. Get info to Patients! (HIPAA mostly good.—"I wanna see my records!") (Detailed hospital-by-hospital, disease-by-disease, doc-by-doc success records a must—despite controversy.)
17. Upgrade IS-IT in the entire system, starting with acute-care institutions. (Current grade: D-.) (Winners include: Indiana Heart Hospital; Inova Fairfax Heart Institute.)
18. Healtheon WebMD-like (if it had worked) mega-, integrated-info network will-should emerge. (A healthcare Google+?)
19. MOVE HEAVEN & EARTH TO IMPLEMENT ELECTRONIC MEDICAL RECORDS. NOW.
20. By hook or by crook, something approximating basic universal care, starting with kids—50 state partial experiments is a help; some are quite far along. ("Market-based" as much as possible—but this is far from a "perfect market.")
21. Deal with the enormous HMO "I want my doc" perception problem. (Fact: MARCUS WELBY, STATISTICALLY, AIN'T THAT GREAT A HEALER IN TODAY'S "HIGH SCIENCE" WORLD! Incidentally, same perception problem re Congress, schools. "My Congressman is great, Congress has 434 other crook-clowns." "My kids' school is good, the system is awful.") · Blitzkrieg of Patient/Customer/Citizen education (e.g., re "outcomes-based HC," "Get the most for your HC dollar"). (Corporate cuts should motivate this.) · "Healing-centric" care supported. (E.g., Planetree model—reduces future problems.) · Emphasize front-to-back "customer care" practices—cuts waaaaay down on malpractice claims among other things. · Specialization in acute care works wonders, regardless of howls! (E.g., Shouldice/hernia repair.) · Shorten the FDA approval process. (Tom, age 63, wants the good new stuff and will accept associated risk; so will most boomers-geezers.) · DON'T MESS AROUND WITH H5N1/AVIAN FLU! Tom Peters posted this today. SINCERELY YOURS

1. RODRIGO GONZALEZ FENANDEZ, CONSULTAJURIDICA.BLOGSPOT.COM