Physicians Leading the Effort to Contain HC Cost

September 3, 2014 at 10:48 AM Leave a comment

I had the privilege of attending the Physician Leadership Summit at Stanford University recently. The conference was put on by the Network for Regional Healthcare Improvement (NRHI) and was hosted by Dr. Arnie Milstein of the Clinical Excellence Research Center. NRHI selected physician leaders from five states to come together and discuss how total cost of care information might be used to improve quality and reduce cost. Now for most people, this is a pretty arcane topic, and you might expect that this was a two day snoozer. In fact, it was anything but.

I worked with my fellow NRHI staff on this for many months, and not without some trepidation. Would physicians get what total cost of care means? Would they feel responsible for it, or would they just feel overwhelmed? And how would they take to the communication challenge, the part for which I was responsible? I worried about all of these things.

In retrospect, I shouldn’t have worried. The physicians I met were without exception profoundly intelligent and decent people. They immediately grasped the potential of understanding total cost of care, and understood how they, as primary care physicians, could reduce cost and improve quality simultaneously. More than that, they understood the leadership challenge of swimming against the prevailing culture for something that is hard to do, but right. They understood it because they have been doing it, each in his/her own sphere, largely unaware there were others laboring in the same vineyard, a few rows over. I am profoundly grateful to have met them, and that they got to meet each other. If you’re going to be digging and planting in the hot sun, it helps to have company.

Pragmatically we will need hundreds and thousands of the kind of physician leaders I met at Stanford if we are to change the way we take care of people for the better, and not just change the way we pay for care. There are many reasons for this rooted in sociology, psychology, and neuroscience that we will go into another time. But to date I haven’t found a way to cultivate such leaders except one by one, and face to face. And so, from this small beginning, I have hope that these leaders will bring others into this field, and that we might bear fruit for the communities in which we live. Salue!

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