On April 7th, Dr. Smith will serve on the panel “Reducing Readmissions for Frequent and Super ED Users at Cook County Health” at Becker’s Hospital Review 11th Annual Meeting. As part of an ongoing series, Becker’s is talking to healthcare leaders who plan to speak at the conference, which will take place on April 6-9, 2020 in Chicago.
To learn more about the conference and Dr. Smith’s session, click here.
Question: What, from your perspective, is the biggest challenge about the future of work for hospitals, and what can they do about it? (i.e. automation, desire for more flexibility, clinician shortages, etc.)
Lauren Smith: Clinician shortages – I believe this is due to an entrance (PCP) and exit (all specialties) vantage. At a time when we are looking to move to more preventative care and truly “healthcare” not “sick care”, we need to increase our numbers of primary care physicians. However, when we are seeing physicians having the burden of student loan debt in the hundreds of thousands of dollars with rising interest rates, Primary Care is a hard sell to medical students. As we know, the field of Primary Care has lower salaries and oftentimes even longer work hours than other, better-paying specialties. In addition, the increased burden on physicians, nurses, and other practitioners, to do more and more non-clinical care, is attributing to many leaving the field of medicine. A majority of physicians chose their careers because of the desire to care for others and the love and respect of the human body and its processes. When time is spent on a computer doing non-clinical tasks or on the phone trying to get a patient a necessary medication, work is less gratifying. Over the last few years, I have seen many friends leave the practice of medicine for other career choices. Reasons vary, but nearly everyone on some level expresses that the stress and frustration with the current system have played a role in that decision. This conversation of “can I leave medicine?” “what are my options if I leave medicine?” is becoming more and more frequent among my colleagues and friends and it is concerning.
Q: What, if anything, should hospitals be doing now given economists’ projections of a forthcoming economic downturn?
LS: In light of the projected economic downturn, hospitals should be focusing on: alignment and cost containment. Hospitals and healthcare systems are stuck teetering between two systems. Fee for service and pay for performance. We have evidence that more does not mean better, for examples, we as a nation spend the highest percentage of GDP on healthcare, with outcomes that are similar or worse than other countries. Important discussions are needed between hospitals and healthcare systems, accrediting and overseeing organizations as well as insurers and pharmaceuticals. Many hospitals and systems are recognizing that silos within their walls have to be broken down, but silos outside of the hospitals are an impediment as well. We need greater transparency between the various entities in order to achieve these two aims. This may require more collaboration between hospitals and health systems, which see each other as competitors, realizing that there is power in numbers. It is time to have these tough conversations with other industries, all stakeholders need to be at the same table. We cannot have pharma or med device companies going rogue, nor health systems and physician groups; we all need to move forward together with shared goals.
Q: How can hospitals reconcile the need to maintain inpatient volumes with the mission to keep people healthier and out of the hospital?
LS: This is a huge challenge for hospitals to maintain inpatient volumes and keep people healthier and out of the hospital. It really calls for total disruption in how we view medicine and provide healthcare. We might be approaching a full circle moment in healthcare when we did more care in the home, and not so much in hospitals – ala Dr. Marcus Welby? Or will telemedicine be a new way? Honestly, I don’t know the answer, but I do know we have to start thinking outside of the box, or rather walls. A hospital is just space, we can adapt them to meet the needs of the consumer, our patients. We are still being too traditional in our thought processes and delivery of services. The consumer is changing and how they want healthcare delivered is changing. It’s time to meet them where they are…. So, it is a stressful time, as change always is, but also exciting as this is our opportunity to make things better for practitioners and patients.
Q: Healthcare has had calls for disruption, innovation and transformation for years now. Do you feel we are seeing that change? Why or why not?
LS: Innovation, disruption, and transformation are coming, but the change is coming too slowly. Unfortunately, in healthcare, “the norm” has been that we move on a 7-10-year span, bench to bedside, and while this is most notably for research, I would venture to say this mentality can be seen in all facets of healthcare. We cannot afford to continue to move at that pace. It appears the tech minds have taken note of this, hence their interest in our industries. Their expertise lies in just this, disruption and transformation. Hopefully, their interest is honorable, and they will be able to help fill this gap and help us speed up the pace in thinking about disruption in our industry and making improvements. While the tech and creative disruptive minds are presenting solutions to healthcare, it is imperative that the offerings be in a safe and effective manner. That is the challenge in healthcare, to be creative and move quickly, as lives are truly in the balance. We must be cautious on one hand but move quickly on the other. We can no longer move at a tortoise pace; the stakes are too high.
Price Transparency in Hospita9ls and Health Systems —
At Becker's 4th Annual CEO + CFO Roundtable, taking place November 2–5 in Chicago, more than 1,500 hospital and health system executives tackle decisions that determine whether organizations thrive or merely survive: protecting margins under cost pressure, choosing where to grow, renegotiating payer relationships, stabilizing the workforce and proving real ROI on technology. This is where leaders work through them together, face-to-face. Apply for complimentary registration now.
