Horsepower (hôrs’pou‘ər) n.
- A unit of power in the U.S. Customary System, equal to 745.7 watts or 33,000 foot-pounds per minute.
- The power exerted by a horse in pulling
I had the opportunit to present to the Managed Care Executive Group yesterday in Chandler, AZ. In a beautiful desert setting, this group of executive IT folks from regional health plans gather to share ideas that will propel them forward in the year ahead. I was the final keynote of three densely packed sessions. The other key noters did a wonderful job describing in thorough detail with graphs, charts, and well documented trends the challenges in our health care system. Given their depth of coverage, all that was left for me was to highlight as succinctly as I could was my perception of the problem with our current health care system:
I call it Ferrari Medicine. The United States is culturally geared to bigger, faster, stronger mentality that is under-girded by a pervasive me-me-me affluenza that demands the very best (as long as someone else is paying for it!) at all times regardless of the cost. The above Ferrari is an amazing machine – one of the most advanced in the world. It has incredible horsepower, finely tuned instrumentation, plush interior with the finest woods and leathers, and exquisite styling and exterior. Unfortunately, given its expense and care requirements, it is not very useful for the 98% of times that you just need to transport yourself from point A to point B. It would be unthinkable, in fact utterly absurd, to use such a masterpiece as this as a pizza deliver vehicle.
However, for alot of what we do in health care, we just push on the gas pedal. We build in more horsepower, more features, more functionality, more procedures, more capacity, and more of everything. However, despite all the appeal of the latest and greatest, the evidence shows that all the capacity within are system actually make the care and outcomes worse! More is definitely not better, and in fact, it is often worse. This has given rise to the concept called Slow Medicine, being advanced by the wonderful folks at Dartmouth. We can often do better with less, being more thoughtful, including the patient in the decision making, and doing the simple things that allow each patient to move from point A to point B in the way and manner in which is appropriate and desired by them.