Monday, October 31, 2011

The Siren Song of Continuous Improvement

This is what medicine has become in the eyes of our regulators:

Federal health officials are seeking physicians and other health professionals for a program to develop leaders in health care innovation.

The Centers for Medicare & Medicaid Services on Oct. 17 announced the Innovation Advisors Program, which will accept up to 200 people in its first year. Advisers will develop projects and processes in their home regions that achieve the goals of bettering population health, improving health care delivery and lowering costs through continuous improvement. They will focus on Medicare, Medicaid and the Children's Health Insurance Program.
Continuous. Never-ending. Infinite.

As if money had no limits.

More. More. More.

More doctors-turned-administrators. More “projects” and more “processes” like Pay for Performance and Quality Measures. More keyboard entry time.

But note that this is continuous improvement but is limited to government programs: a fact that contradicts the word "continuous."

The implications to policy makers who use such trendy buzz phrases like “continuous improvement” is that doctors and current public policy workers aren’t already working to constantly improve our patients’ health. Instead, we are messy, doing expensive things that involve too much time and too much money.

So new programs must be developed and their processes measured to see if they work.

Isn’t this the point of "continuous improvement?"

So the government's answer for continuous improvement is to acquire 200 more Anointed Ones woven from the same cloth to help us all "improve." (Well, at least for the first year. No doubt more will be needed in the future. “Continuous,” remember?)

But there's another, better way.

It's a way that will save (literally) billions upon billions of dollars ffor our health care system and taxpayers of this great country. Best of all, it's simple, effective, and guaranteed to work:

Stop continuously improving projects and processes that don’t exist.



Tim Hulsey, MD said...

Bureaucrat- a) one who continuously improves projects and processes that don’t exist!

b) One who has to find ever newer duties to justify their own existence.

c) similar to Congress- a legislative body who never recognizes a time when new legislation is not needed.

Keith said...


We have for years devoted our research dollars and energies into the lucrative areas of cardiology and oncology with some impressive gains.

Don't you think it is about time goverment offered the same research and investment opportunities to how we deliver health care? After all, no one is going to fund studies that actually might cut the costs of helath care and Help save our goverment from crushing costs. For goverment to continue to do things the same old way is just plain suicide for us all.

I just saw a quote on Paul Levy's web sight from Dr. Kim at Dartmouth who states "health care delivery is the rocket science of health care". TIme to work on better solutions for more efficient health care delivery instead of constantly investing our dollars in expensive devices that offer up marginal value for extortion like prices.

Tim Hulsey, MD said...

Keith said, "Don't you think it is about time goverment offered the same research and investment opportunities to how we deliver health care?"
Yes, what people in this country need is diverting as much attention as possible away from actual patient treatment. Don't you think the Parkinson's patient will just love to wait for a cure until the bureaucrats finish talking about the shape of the conference table?!
We certainly want to look to the government for advice how to do things more economically, more efficiently, and more predictably! For example, Obamacare is beginning to look like the knight from Monty Python: "It's only a flesh wound!"

ShakesandStones said...

It really identifies a floor in democracy. Don't get me wrong, I am a great believer in democracy, but politicians are hell bent in creating legislation that can provide a short term benefit before the next election.

Realistically what is needed is longer term approach that will cause a little pain in the short term but will reap massive gains in the long run, allowing the doctors to practice medicine, not administration, and saving lots of money which can be repurposed to help the patient. After all, isn't that what it is all about?