Much of the discourse on the current state of U.S. healthcare centers on the rapid pace of change, an uncertain future and serious financial challenges for patients and providers alike. With the recent presidential election of Donald Trump and the likelihood that the ACA will be fundamentally changed or repealed, the future of U.S. healthcare is less certain than ever.
But despite the turbulent nature of the healthcare environment, clinicians and leaders must not throw up their hands in the face of these challenges, many of which have become defining characteristics of the industry. In fact, many people hold misperceptions about these commonly bemoaned issues, according to Charles Sorenson, MD, president emeritus of Salt Lake City-based Intermountain Healthcare.
"As healthcare leaders, we all recognize we live and operate in a very tumultuous time," Dr. Sorenson said at Becker's 5th Annual CEO + CFO Roundtable Nov. 8 in Chicago. "But I don't want to overstate that. I've worked in healthcare for more than 40 years and I don't recall any time where things were status quo. It's always seemed like big change was imminent."
Although bigger changes in the healthcare industry have occurred more rapidly in the last five years, healthcare leaders and providers have shown they can handle the transformation, according to Dr. Sorenson. The most important tool individuals and organizations can wield in the face of change is a positive mindset and the ability to identify opportunities and truths hiding beneath the surface of the unknown.
Here are 10 commonly held misperceptions about healthcare and their corresponding realities, according to Dr. Sorenson's experience at Intermountain Healthcare.
Misperception 1: What matters most in healthcare is who gets elected.
Reality: "I am asked quite frequently how the outcome of the election will affect healthcare," Dr. Sorenson said on the morning of Election Day. "It does matter who is elected because the next president will have a big influence on regulatory changes in profoundly meaningful and expensive ways."
Ultimately, however, it is up to healthcare providers — not the president — to fix healthcare's issues. "It's up to us who are deeply involved in providing healthcare, insurance, research and innovation. If healthcare is going to be reinvented, it has to be done by us," he said.
Misperception 2: High quality care costs more.
Reality: The notion that higher quality anything costs more is a concept that is deeply engrained for consumers. While it's no doubt that quality and costs are linked, Dr. Sorenson said they are connected in a "counterintuitive way." "Our experience at Intermountain shows that higher quality care leads to less costs overall for the population served," he said. "Higher quality doesn't necessarily decrease the cost of the delivery system but it lowers costs overall."
By following best practices and eliminating processes that don't contribute to improved outcomes, hospitals and health systems can reduce waste and provide better care at a lower cost.
Misperception 3: High-tech tools lead to better care.
Reality: While advances in technology have been instrumental to the diagnosis and treatment of many conditions, expensive new devices often add only costs — not health benefits — to care.
Misperception 4: Every patient wants every treatment that could possibly help them.
Reality: Patient education has emerged as a central imperative as consumers increasingly sign on to high-deductible health plans and become more financially responsible for their medical care. While many providers believe patients are inclined to want a high volume of treatments, fully informed patients are more likely to agree with their physicians' evidence-based treatment plans, according to Dr. Sorenson.
Misperception 5: Physicians shouldn't be concerned with the cost of treatment.
Reality: "During our training, we were told it was unethical for us to worry about costs — that was for someone else to worry about," said Dr. Sorenson. "But we didn't have the cost pressures back then that we have now."
Most physicians understand that a fee-for-service system is not sustainable, and "society as a whole is running out of money," he added. "Protecting our patients' resources is part of our responsibility in taking care of them."
Misperception 6: Population health management is equivalent to rationing.
Reality: Population health management and value-based care is intended to keep patients healthy by managing chronic conditions and preventing illness to lower the chance of complications and subsequent costs down the road, according to Dr. Sorenson. It is not that population health management efforts require rationing, but rather that they require the elimination of services and processes that impose high costs and don't yield better patient outcomes.
Misperception 7: It's impossible to get people to change their behavior.
Reality: "It is hard to get people to change something just by telling them to," said Dr. Sorenson, "but if there's a social connection they can sympathize with, they will be more willing to change." Dr. Sorenson pointed to the increased rate of seatbelt use and decreased prevalence of cigarette smoking as examples.
Misperception 8: Physicians exist to create health and fix problems.
Reality: Physicians are around to create health among the ill and injured, but they are also key players in efforts to promote and sustain wellness among the healthy, according to Dr. Sorenson. Viewing physicians exclusively as healers of the sick doesn't align with the goals of population health management and value-based care.
Misperception 9: Doing well financially means doing more.
Reality: "That might have been true in a fee-for-service world, but doing well financially as a society means doing the right things for patients," said Dr. Sorenson. "That means doing things that produce better outcomes and preventing illness wherever we can."
There will always be people who require complex medical treatment, but if providers are better at keeping people healthy, the healthcare industry won't need to spend such a high proportion of the country's resources, added Dr. Sorenson.
Misperception 10: The future of healthcare is bleak.
Reality: "To the people who despair, who think their chosen profession is becoming too difficult and is failing, I disagree," said Dr. Sorenson. "We now have an unparalleled opportunity to make healthcare better for the people we serve and to make it better for the people who choose this noble profession."
The healthcare industry is already equipped with the right tools — the expertise, people and technology. All it lacks is the confidence required to confront a big challenge. "Each of you who are involved in healthcare have a demanding and stressful job. But when you go home, tired and spent and stressed out, ask yourself, 'What would I rather be doing?'" he said to the audience. "What could be more worthwhile than caring for the thing others consider to be the most precious — their lives?"