Editor: Fairness in Healthcare. ‘If I can’t do it for everybody, I’m not going to do it for anybody’ … But in a culture characterized by a collaboration is the opposite is true?

Innovation Starts Expensive, Then Eventually Develops Into Things We Can Afford. That’s how it works.

Example: A microscope that costs less than $1. A post-natal incubator for $25. These TED Talks highlight exciting innovations that render formerly-expensive things affordable — whether it’s to save you money, or to save lives. The year is 1800.A curious little invention is being talked about.It’s called a microscope.What it allows you to dois see tiny little lifeformsthat are invisible to the naked eye.Soon comes the medical discoverythat many of these lifeforms are actually causesof terrible human diseases. (Listen)

Take for example, the Stethoscope.

It took time to get to the device around your neck we see today. It took concepts that worked and didn’t work. It had patents and prototype costs. Production time and costs of materials. Prices today vary from $5 to $160 and even go higher. Acoustic stethoscopes, which allow the user to hear inside the chest wall but do not amplify the sound, cost between $5 and $160. The Omron Sprague Rappaport stethoscope costs about $20. This stethoscope was named a best buy by For Us Docs[2] magazine. The Littmann Cardiology III[3] costs $160. Developed in the early 1800’s, the word stethoscope is a combination of two Greek words, stethos(chest) and scopos(examination). Doctor Rene Theophile Hyacinthe Laennnec was examining a young patient when he discovered he could clearly hear heart sounds when he rolled up a piece of paper to create a tube and place it in his ear. It was amazing that he could hear the sounds of the heart so clearly!! This discovery lead to the development of the first stethoscope which was made of wood and was used with one ear. It was quite similar to the hearing aid of that time which was called an ear trumpet. In the mid 1850’s the stethoscope underwent a major improvement—it was made to fit both ears! Dr. Arthur Learned was to make enhancements, which were later improved by George Cammann in order to make it fit for commercial production. In the 1940’s further changes where made and the stethoscope now resembled what we see today in hospitals and doctors offices around the world. The two sided stethoscope was also invented, one side is used to listen to the heart the other is used for listening to the lungs. Only minor changes have been made since then. These changes include making them lighter, having better fitting earpieces, and are better at filtering out outside sounds. Source: www.baronmedical.com/blog/the-history-of-stethoscopes/

Another example, the Ultrasound Machine.
Most new ultrasound machines fall in the $20,000 to $75,000 range. Used or refurbished machines – which offer a great opportunity for saving money – usually run $5,000 to $40,000 for average models. The GE Voluson E8 Expert BT06 Ultrasound Machine starts at about $115,000. Yet, patients today can find their own version (yes, maybe unsophisticated and elementary and imprecise), on Amazon for as low as $59.99.
The point is, innovation has phases. Things take time. They always start out costing more and then years, sometimes decades later, they begin to enter the market if there is a need and get cheaper.

What is the longest patient visit or exam you’ve EVER had with a Patient? Is is 90-minutes? Was it 2-hours? What if I told you one Concierge Doctor we spoke with recently said she spent more than eight hours with one patient? Why does this example matter? Well, it matters a lot. It sets the bar for others in the delivery of healthcare REALLY, REALLY high? In fact, Concierge Medicine’s obsession with building close, positive relationships with its patients is perhaps their greatest driver of its success over the past twenty five years. Every call, every patient interaction, each smile from a staff member, every text message … represents an opportunity to “wow” someone. It’s an opportunity to turn a one-time Patient into a loyal, repeat Patient, thus ensuring future patient retention and more thoughtful, caring interactions between Physician and Patient.

Editor-in-Chief, Concierge Medicine Today, Michael Tetreault

By Michael Tetreault, Editor-in-Chief, Concierge Medicine Today, Host, The DocPreneur Leadership Podcast

Every person has an opinion on healthcare don’t they?

But not everyone lives in your shoes as a Physician, do they?

They can’t possibly know what it’s like to wake up in your shoes and face the impossible tasks you choose to confront day in and day out.

You’re job is tough. Dare we say, impossible.

I’ve recently been listening to a lot more podcasts to further enhance my knowledge on various topics.

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Some are about healthcare [most actually], some are for pleasure [candle making and canoeing] I know right, weird! 🙂

And some talk about leadership and have helpful translation into healthcare.

One topic about misnomers in customer and organizational cultures caught my attention. I listened to it over and over.

CMT’s 2020 Peer Recommended Book FOR DOCTORS, Nurses, Staff, PAs, NPs, and More … Full List Available … LEARN MORE …

The author and writer, Andy Stanley said in the podcast “… you remember growing up we heard teachers say all the time ‘Well if I do it for you I have to do it for everybody … ‘ [So in essence] the reason I couldn’t get an extra Brownie in the school lunch line is … If I gave you one I have to give everyone one. And of course we all thought the same thing when we were told that by an adult ‘uh, no you don’t. You could actually just give me one. It’ll be our secret.’I think somehow this got imprinted in our mind and it became unfortunately a leadership Maxim. ‘If I can’t do it for everybody I’m not going to do it for anybody’ but in a culture that characterized by a collaboration the opposite is true. We look for opportunities to do for one what we wish we could do for everyone and honestly I think sometimes leaders hide behind this I think sometimes.We don’t want to do for anyone what we can do for one … so we hide behind this and say ‘well, if I do it for you I have to do it for everyone’ and I think every once in a while we just need to look in the mirror and ask ourselves ‘Okay, am I hiding behind this?’ If so I’m certainly not modeling something I want throughout the organization because as leaders … and just think about this for a minute … think about what would happen in your particular sphere of influence if everybody within your sphere of influence looked for an opportunity to do for one or two to do for one another what they wish they could do for everyone.I mean everything gets better especially the relationships within the organization so this is in some ways again it’s symbolic leadership. But it’s important leadership and I believe it trickles down throughout the whole organization if a leader models this and then appropriately let it be known how they model this again as we said before it’s not enough to leave well you have to be seen leading well and this is one of those areas where people need to catch us leaving well in modeling this principle. I know what perhaps some of our podcast listeners are thinking they’re like well … ‘wait a minute but that’s not really fair.’ And you’re right. It’s not fair. Do not try to be fair because you cannot be fair. Give up on fairness and be engaged and if you do for one what you wish you could do for everyone you will be engaged and you will model something that can be replicated. If you try to be fair, if you try to treat everybody the same way … at the end of the day you won’t and besides that’s not really what we want to characterize are companies. I mean have you ever heard or read an article about a company that thrived because the company was so fair? ‘We just treated everybody the same and we made sure that everybody got exactly what they deserve.’No, that’s not a leadership principle. In fact you know that’s like trying to lead with both feet on the brakes. So ‘do for one what you wish you could do for everyone’. ~Source: Andy Stanley, Podcast: Creating a Culture of Collaboration

I love these statements because it so beautifully describes what a Patient wants out of their relationship with their Doctor.

Healthcare has tried to be fair. It hasn’t worked.

Some might argue it is working. In Canada for example and other countries with socialized medicine.

But have you actually heard how Patients and Doctors react and interact with each other in these systems. We have.

Some of the stories are great, but many are not.

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For illustration purposes, here’s a story from Canada that caught our eye.

Under the Canada Health Act, everyone should be entitled to the same level of care irrespective of where they live, states Canadian Physician, Dr. Mark Brown, an advocate for creative changes to improve health care — for patients and physicians.

In the Regina Leader-Post recently … While doctors’ house calls are a thing of the past, imagine patients connecting with their physicians through Facetime, telephone or secure email instead of needing to walk into the office. It’s the vision of Dr. Mark Brown, an advocate for creative changes to improve health care — for patients and physicians. Dr. Brown was noted in the article stating … If family physicians are involved with patients’ care when they’re in the hospital and their transition home, the likelihood of them being readmitted goes down dramatically. “Some provinces like British Columbia have realized this and so they’ve focused some resources to encourage family doctors to stay connected with their patients when they’re in the hospital under somebody else,” he said.

Mihaly Csikszentmihalyi says “A business is successful to the extent that it provides a product or service that contributes to happiness in all of its forms.”

A lot of great Doctors understand that every patient is different. Sure, some may ‘present the same’ they say, but genetically we’re different. It’s nice to know certain drugs will work for many individuals. But, some won’t. Great Doctors, understand you sometimes have to go the extra mile and ‘Do For One What You Wish You Could Do For Everyone.’ You identify it every now and then and you do it because it’s the right think to do. Right?

There will always be criticism. Especially in healthcare. Everyone has an opinion on healthcare. But not everyone lives in your shoes. They don’t see what you see each day. They don’t live with the regret or the pain or see the emotion or wade through the mental health and physical challenges that you willingly walk into each day.

All we’re saying today is that for a few of you … remember these words:  ‘You’re right. It’s not fair. Do not try to be fair because you cannot be fair. Give up on fairness and be engaged and if you do for one what you wish you could do for everyone you will be engaged and you will model something that can be replicated. If you try to be fair, if you try to treat everybody the same way … at the end of the day you won’t and besides that’s not really what we want to characterize are companies.I mean have you ever heard or read an article about a company that thrived because the company was so fair? ‘We just treated everybody the same and we made sure that everybody got exactly what they deserve.’No, that’s not a leadership principle. In fact you know that’s like trying to lead with both feet on the brakes. So ‘do for one what you wish you could do for everyone’.

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