In the heated debate surrounding health care reform in the United States, one thing is consistent and urgent: waste is expensive to our country's health.
As Americans, we are now hearing that so many diagnostic tests that we once had may never really have been necessary at all, or certainly not as frequently as we had them. (Consider the prostate cancer screening debate or the battle over recommendations for screening mammography.)
We hear about the proliferation of unnecessary end-of-life tests, procedures and protocols that serve not to prolong life but to "standardize care" and protect hospitals and providers from the risks of liability. We also experience for ourselves, as we move from primary care to specialty treatment, the frequent repetition of blood draws, diagnostic x-rays, and the resubmission of our personal and medical insurance information. Over and over again, we question what is actually "necessary" in our care and what is just a standard or a health care provider wanting to do things over their way?
Is the U.S. health care dollar being wasted by duplicating tests and treatments? Who is monitoring the individual patient outcomes over the general data, trends, and financial outcome? Robert Kelley, vice president for Health Care Analytics at Thomson Reuters, did an impressive analysis of where we could save $700 BILLION in costs through a reduction in waste.
But there is other waste in the U.S. health care system that may be just as insidious as "medical narcissism." Health care administrators, hospital CEOs and physician practice plan managers are not immune -- spending money and resources on problems that were already addressed and solved at other hospitals and organizations exactly like their own. Many health care leaders feel compelled to "do things their own way," because that is just the way that its always been done: recreating the proverbial wheel, distrusting templates, hiring consultants, and believing that "originality" is always demanded of them. This is another form of waste in our health care system, and, perhaps, ultimately an easier fix than many other costs in direct patient care.
For example, the cost of a nursing strike at an average U.S. hospital costs millions of dollars in temporary staff, legal fees, and consultants. What if there was a solution that another hospital had used successfully to prevent or swiftly negotiate through the crisis and it was available at a fraction of the cost? "Franchising" proven solutions hospital-to-hospital is a way to also save billions of dollars in our U.S. health care system. An online company called MX.COM (www.mx.com) has recently launched to be an "eBay of health care solutions," a clear channel that allows hospitals to share effective solutions to common problems -- some even at no cost. (For an article written by MX.COM founder Dr. Joseph Davis click here.)
Narcissism IS bad for our country's health. We as health care professionals need to learn to trust each other and try on each other's solutions to the difficult challenges facing our health care system. There is not time for waste, duplication or for re-inventing the wheel. Health care should be about community support, shared values and respect. Let's let go of ego and give it a try.