Walkabout (wôk’ə-bout’) n.
- A temporary return to traditional Aboriginal life, taken especially between periods of work or residence in modern society and usually involving a period of travel through the bush.
- A public stroll taken by an important person, such as a monarch, among a group of people for greeting and conversation.
I have been off the grid for the last several months heads down on a project which is the cumulative result of my last three year walkabout. Each of the experiences I had along the way provided a stepping stone and preparation for the path that I have recently embarked on.
After a couple of years of talking about health deliver reform (starting with Redefining Health Care), health care financing (Health Equity), health plan innovation (Lemhi Ventures), new practice models (Current Health), and health care reform (X PRIZE), I was left feeling like I was nibbling around the edges without having anything to sink my teeth into. The X Prize proved to be the catalyst, as I had to think about which side of a competition I wanted to be on (Administration vs. Competition). As a former collegiate athlete, there was never a question that I would choose to compete. As my contribution to that project wound down late in the fall, my decision was made – it was time to hang up the Blue Blazer and Khakis and put the stethoscope back on.
I used to think that I had moved on beyond being “just” a physician. I always respected and appreciated the work that went into becoming a doctor. But along my journey, I somehow lost the appreciation for what it means to be a physician – a trusted heath advisor, a healer, and someone who people turned to with confidence during some of the most difficult times in life. Perhaps the shift work in the ER, the patient population I dealt with on a daily basis, and certainly the shiny objects flashing on the always greener side of the fence were contributors to the reasons I chose to pursue other interests outside of the practice setting.
Ironically, those same interests have led me on a walkabout journey that has come full circle. When we founded Medsphere, the market was at a tipping point for implementing EHR’s. Those were the days we had to convince people that EHR’s were a good idea, that the VA was a benchmark for automation, and that open source was actually a viable development and business model. Our thought was always that the implementation of the EHR was the first step, that you absolutely needed to get an information gathering infrastructure in place in order to even consider improving health care delivery. We often talked about our second company, which would be a data analytics powerhouse that could create actionable work plans to turn the data into information and ultimately knowledge about health care performance. Health care delivery is where the action is, because that is where the monetary and resource allocation decisions are made. Its also where the rubber truly hits the road. I have since become convinced that no matter how fast your rev your RPM’s (health care hype), it is in the friction, heat, grime, and gristle of contact (physicians “touching” patients) that true progress can be made.
Its also where we need the most help with innovation.
Health care delivery is woefully behind most other professional service industries in nearly every measurable criteria. Our customer service is atrocious, our efficiency metrics don’t even register, and we certainly can’t provide very good guidance to our patients when we practice in a data free environment. Beyond just being a typically conservative industry, our cottage nature is confounding and for a profession that highly leverages the peer review process in sharing knowledge, we take a parochial perspective when sharing best practices. As a result of these and many other factors, the way our profession is compensated has morphed in negative ways to the exclusion of some, the short term gain of others, and ultimately to the demise of all.
I think we can do better; I know we can do better; and I look forward to being a contributor to the required change. Given my cumulative experiences, I believe the way that I can have the most impact is in the actual “rubber meets the road” delivery of care. As a physician, it is my privilege to touch patients through practice delivery innovation that incorporates the best thinking, technology, and talent that can achieve the best outcomes. All that I have learned, experienced, and seen during the last several years is going to be leveraged in the creation and implementation of Crossover Health.
I look forward to having you join me for the journey.