I spent almost all of my 40+ year working career involved in looking at the healthcare patient as a customer or end-user. Though we do our very best to consider our products and care from the patient’s perspective, it just isn’t the same as when you are that person in the hospital bed whose life and well-being depend upon those same products and services.
Over the last couple of weeks, I found myself looking up from the hospital bed again. This time, I had a total knee replacement. The procedure was relatively quick (about 45 minutes) and the hospital stay short (one night). But, it is amazing how such an event allows exposure to the entire healthcare system, end-to-end. For this surgery, I had x-rays, diagnostic blood tests, surgery, anesthesia, hospital care, physical therapy, home visits, pharmaceutical products, medical device products, etc. that illustrate both the good and not-so-good of our healthcare system.
Today, I would like to cover a few insights and perspectives that I have gained from this most recent experience. Keep in mind, this particular journey isn’t yet over… I am only about 18 days post-op. But, I think it is worth sharing what I have learned and observed that might benefit others.
- Everyone loves to hate opioid pain medications… until they need them! – Opioid pain medications are on everyone’s evil drug list these days. While it is true that many ills in society are due to the addicting nature of these products (e.g., morphine, oxycodone, hydrocodone, etc.), try having major surgery without them! These products have an amazing ability to temper or eliminate the severe pain associated with surgery. I often find myself watching the clock in anticipation of my next pain-relieving dose. Thus, it is easy to see how one might become overly dependent on them. Finding that balance between benefits and risks is a challenge that we must somehow achieve. For now, I credit a large degree of the success of my surgery to opioids. For without them, I would not have been able to withstand the physical therapy that differentiates success from failure of this joint replacement.
- Healthcare is becoming more patient-focused and outcome-based – I have definitely seen a shift in medical care toward results. Before choosing my surgeon, I studied his success and complication rates through internet searches. His standard protocol for post-op rehabilitation has changed in recent months to accommodate new research on eventual outcomes. Insurance companies have become much more focused on ultimate results and will withhold payment on treatments that are not statistically justified. Entire healthcare teams and individuals continuously seek input from customers (e.g., patients) through surveys, opinion polls, and feedback mechanisms. Of course, some of this outcome-based emphasis is good and some not-so-good. When it is directed toward continuous improvement of care and patient satisfaction, it is certainly good. However, when merely used to limit or shift costs and reimbursement, it falls short of desirable.
- Strong teamwork and highly coordinated processes are replacing the silo treatment approach of the past – For my most recent knee replacement surgery, I have been amazed at the end-to-end teamwork evident. My past experience was that each phase of the process (surgeon, administrative, physical therapy, communication, etc.) was handled as a stand-alone entity. The surgeon did his work, then passed you along to the physical therapy team, etc. However, in this case, every piece of the process was coordinated and tied to each other piece. Prior to my hospital discharge, home visit appointments were made with a nurse and physical therapist. Everything needed for recovery was arranged and scheduled. A training session occurred before surgery that included my “joint coach” to ensure we both knew what to expect and what we needed to do together to be successful. I have been pleasantly surprised how each element of process has been integrated with each of the others.
- Though patients have become more educated on healthcare options and expectations, every individual journey is unique – I have to admit that I probably read too much information on total knee replacement surgery before my own procedure. Though most of the information available on the internet speaks to the positive outcome expected, there are always horror stories that make you second guess your decision. Nonetheless, a patient these days can watch videos of actual surgeries, get a report card on the surgeon and hospital, get hundreds of testimonies from others that have experienced the same surgery, and be very knowledgeable on all aspects of the procedure. You can even “shop” various knee joint manufacturers for options, benefits, etc. in much the same way you might shop for a new car online! Despite this vast amount of available knowledge, the outcome and recovery for each patient is unique. My progress is different than anyone else that has ever had this surgery. Thus, all of this newfound knowledge doesn’t replace listening to the advice of the surgeon, therapists, and adhering to the program they outline.
- A shift to modern analytics-based care is occurring – Every individual I encountered throughout my journey, thus far, has been extremely knowledgeable and professional. However, it is evident that the modern approach based strongly on analytics, trending, remote monitoring, etc. has not yet been fully embraced. Most have adapted well to this approach. However, some still prefer the “old days” of patient care and personalized service. I think this scenario plays out in every discipline and every field… some individuals prefer “the way we did it in the old days” to today’s approach. Both approaches are effective, but, perhaps, both are not equally efficient.
- Everyone is a specialist – It has been clear to me these last few weeks that almost every person in the healthcare industry today has specialized in something. My surgeon specializes in knees and hips. It seems that the nursing staff has also migrated toward specialization. Has the day passed where an individual can successfully function as a “generalist” or must we all have one or more specialties to thrive in this new age?
I have been extremely satisfied with my care and recovery, thus far. I am doing my share to ensure a successful outcome, but I have been highly impressed with both the approach and individuals I have encountered along the way.
And, I think it is good to occasionally consider how the healthcare industry is changing. By doing so, we might conclude that changes to other pieces of the industry must also change (e.g., R&D, manufacturing, quality, engineering, etc.). When you look at the key six points I have outlined above, you’ll find these key topics that apply to everyone in every industry:
- risk/benefit assessment – seeking an appropriate balance
- outcome-based results – adding value
- strongly integrated teamwork – collaborating for the ultimate good of the customer (patient)
- continuous learning – educating yourself, staying current, seeking innovation
- embracing change – a willingness to accept a new approach, especially when the value is demonstrated
- specialization versus generalization – enhancing our personal value by enhancing our expertise
So, the question we should be asking ourselves is, “Am I doing what I can to enhance to ultimate experience for my patients, customers, coworkers, family, or associates?” I think there is something here that can help each of us become more valuable to our company and to others that we serve.
Have a great day!