Health Care Business

Giving physicians more say in how to incorporate technology into their work is good for patients, and the field.

If you want to discourage a worker, subject them to policies and procedures that don’t make sense. This principle was first described by Frederick Herzberg, an American psychologist who developed one of the most widely studied theories of workplace motivation. Unfortunately, Herzberg’s principle is being widely applied today in medicine. Changes in healthcare payment systems, the use of information technology, and the doctor-patient relationship have left many doctors deeply discouraged.

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It is easy for many healthcare leaders to forget that doctors go into medicine not because they enjoy entering data into complex electronic health records and ensuring that their employer gets paid for everything they do, but because they want to make good diagnoses, prescribe appropriate treatments, and help patients.

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What can be done? Weygandt argues that doctors need to play a more active role in all aspects of healthcare’s future, not just implementing but also designing it. Too often, such decisions are currently being made by people who do not take care of patients, and in many cases, have never cared for patients.

“Every innovation should be tested not just to see if it increases revenue or cuts costs,” he says, “but also to ensure that it enhances the doctor-patient relationship.”

Everyone involved in contemporary healthcare—patients, doctors, nurses, hospital administrators, payers, and politicians—needs to recognize the importance of preserving and promoting medical professionalism. Good medical care is an art as well as a science, and the professionalism of doctors is at its core. “Doctors should be encouraged to think first not of their own incomes but the needs of their patients, and that means designing systems that keep the patient front and center.”

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New technology can do a better job of helping doctors practice better medicine.... But change isn’t easy. ...

As Frederick Herzberg would put it, “If we want doctors to do better work, we need to give them better work to do.” Medicine practiced well—in such a way that it really makes a difference in the lives of patients, families, and communities—is a great deal more fulfilling than medicine practiced poorly. If doctors are to enjoy the opportunity to make such a difference, they must cease to be the tools of their tools, and instead become their designers.

I recently interviewed Alan Kravitz, Founder and CEO of Medsys, and he offered an insight into the challenges hospitals face that I hadn’t heard before. Here’s what he said:"Expense growth is expanding faster than revenue growth for the first time in healthcare."

This is really interesting to consider when you think about the billions of dollars that are being spent on EHR software. Although, I don’t think it’s the EHR expense that’s the issue. Sure, it’s now a part of the cost of running every hospital. Plus, we could certainly argue over whether it’s worth the cost and whether the EHR is overpriced. However, there’s something much more challenging at play.
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n you think about the political landscape for healthcare, all you hear about is the rising costs of healthcare. You also hear other things like the huge percentage of GDP that come from healthcare and how we spend so much more money than other nations around the world. With all of these things, there’s a huge drive to stop paying so much for healthcare.

When you look at this trend from a hospital perspective, all you hear is that they’re going to be paying us less for doing the same thing (and some might argue for doing more). With this in mind, Alan’s quote above makes more sense. A hospital’s revenue growth is declining and that’s by design. I’m not sure most organizations are ready for this change.

We’ve long heard about the potential of EHR to lower costs. Considering the pressures hospitals face today, we could really benefit from EHR living up to its potential. If not, I’m not sure where hospitals are going to cut.