Transforming healthcare in the era of Trump: An opportunity to disrupt

Posted: 20 January 2017 | | 2 comments

With Trump’s rule imminent, President and CEO of Thomas Jefferson University, Stephen Klasko, puts forth a manifesto for healthcare reform, disruption and change…

President Elect Donald Trump has a unique opportunity to fundamentally disrupt a fragmented, expensive, inequitable, and illogical healthcare system by making a “deal” that puts patients first.

It’s our chance to ensure that healthcare will finally enter the consumer revolution.

Every millennium there is a confluence of events whereby fixing the existing reality is not enough, but rather a new model needs to be created. Steve Jobs did it by turning Apple from a computer company to a digital experience company.

Changing the reality of healthcare won’t be easy, but it can be done. We are already seeing 12 disrupters that enable transformation—disrupters that transcend politics.

I propose that we get over ourselves and for democrats and republicans alike to agree on 12 disruptors for the demise of the old healthcare.

What are these disrupters?

Some involve turning healthcare into consumer facing business, in which new generations, new consumers and new entrepreneurs will outstrip our traditional business models.

Some are opportunities we can and must embrace to change the reality of healthcare disparities, physician practice and the tortured path of reimbursement.

Addressing these disrupters will enable President Trump and the new administration to move forward with alacrity. The time for political rhetoric is past. It is time for meaningful action. 

This is why transformation is much more than ACA.

ACA did what it intended to: Increase access. But we have in no way disrupted the system enough to break the iron triangle of access, quality and cost that healthcare economist Bill Kissick, MD, spoke about 50 years ago.

Here’s my manifesto for change:

I remain completely optimistic about transformation.

And that’s my message as a new administration settles in: Embrace transformation.

  1. Embrace the consumer revolution to make patients first. Train new teams to make healthcare entities into consumer enablers.
  2. Pay for health, not volume of procedures.
  3. Find the right solution for the right patient at the right time. Yes, we have to personalise care.
  4. Select and educate physicians of the future – empathy, not memory. Leave memorisation to the computers and let physicians be the humans in the room.
  5. Ensure that every surgeon can prove competence. Never again, “see one, do one, teach one.”
  6. Do not build new inpatient beds. Shift the locus of health to the home, neighbourhood, community, family. Embrace retail medicine and telehealth.
  7. Always send a believable understandable bill.
  8. Practice integrative medicine.
  9. De-fragment innovation and research – push universities, hospitals and private industry to build creative partnerships for change.
  10. Build a truly integrated electronic health record. We overestimate technology in the short run, but we underestimate it in the long run. The computer will become the concierge of the future.
  11. Understand systems thinking – cost, access, quality. You cannot fix one thing and hope it fixes the system.
  12. End healthcare disparities. If we embrace many of the disrupters above, we will have an unprecedented opportunity to shift how to we encourage health and end the tyranny of the zip code.