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What former Sen. Bill Bradley had to say to Southcoast physicians about health care reform ...

 


SWANSEA, Mass. — Former Sen. Bill Bradley called for health care reform that focused on the "health of the patient" and a new system that offers "total transparency" for quality and cost last night at the Southcoast Hospitals Group physician annual meeting.

"I think we have the best health care in the world, but we do not have the best health care system," said Bradley, addressing more than 170 Southcoast Hospitals Group physicians in Swansea. 

"The health of the patient has to be the central goal of the entire system and incentives [for hospitals, physicians, insurers and medical device manufacturers] have to be aligned to achieve that objective," he said.

"We need to be clear: There are no partial answers. The goal is to improve the overall health of all people, to keep our technological edge, to cover the unexpected [health incident] and to allow people to die in dignity."

Bradley, who is now a managing partner at Allen & Co. in New York and hosts a radio show on Sirius XM Radio, was invited to speak through Rev. Dr. Robert Lawrence, Pastor Emeritus of the First Congregational Church of Fall River and a longtime supporter of Southcoast and Charlton Memorial Hospital. 

"Southcoast physicians were honored to host Sen. Bradley at our annual meeting. During a tumultuous time in our nation's economy and the ongoing challenges of health care reform, the Senator offered some interesting perspectives as the debate continues over the future of health care in the U.S.," said E.J. McMahon, MD, MBA, FCAP, Chief Medical Officer for Southcoast Hospitals Group. "We are extremely grateful to Rev. Lawrence for making it possible for our physicians to hear from Sen. Bradley."

Bradley's vision for health care reform included national health goals for all hospitals, physicians, insurers and the government, including reducing infant mortality, addressing diseases such as diabetes and having "total transparency" of the system.

"We need total transparency on quality and cost," he said. "We need to be able to look into every hospital to see what is happening on that day, in that month or in that year. [Hospitals and physicians] should be paid for how well you manage a patient's care over the course of an illness — from diagnosis and treatment to rehab to disease management."

With health reform being debated in Congress and in the news media, Bradley said bipartisan support would be essential for achieving reform. That means combining universal coverage with tort reform.

"We need to use conservative means to achieve liberal ends," Bradley said. "Everyone should be covered with a basic benefit. There can always be an option to buy more deluxe coverage. Insurance companies will have to compete to provide the best plans. And we need genuine malpractice reform with medical courts that have experts as judges. 

"Universal coverage and malpractice reform — put them together and you get 70 votes."

Like most of society, Bradley noted that health care is increasingly operating in a more globalized world, including treating diseases that jump international boundaries and using telemedicine to read X-rays and other tests.

"What's important to keep in mind is the context in which we are doing reform — globalization," he said. "Diseases are spread globally, just look at SARS and swine flu. We live in a globalized, highly technological world and health care is part of a global supply chain."

As evidence of a broken health care system, Bradley pointed to some "sobering statistics," such as runaway costs, which he said have outpaced inflation by as much as three times, and medical errors that cause 195,000 in-hospital deaths each year. The U.S. also leads the world in obesity, is 12th in life expectancy and 17th in infant mortality.

Some 47 million people in the U.S. currently go without health insurance, which Bradley said is equivalent to all of the combined population of Minnesota, Iowa, Missouri, Arkansas, Louisiana, Oklahoma, Kansas, Nebraska, South Dakota, North Dakota, Montana, Wyoming and New Mexico.
"Hospitals are like every other player in this drama — you can imagine better days with a different system," he said.

With regards to how the estimated $800 million to $1.2 trillion tab is funded, Bradley said $625 billion would come from new taxes but the balance would need to be found in the way health care is delivered and in malpractice reform. Businesses currently receive an annual federal subsidy of $160 billion for health care, which could also go toward paying for reform.

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Customer service lessons from the London Underground ...

While constantly being reminded to "mind the gap," it occured to me there's some customer service lessons to be learned from the London Underground. Especially for us in health care.

Lesson No. 1: Keep talking.

OK, the Brits seem to love to talk — and often use more words than necessary. But beyond "mind the gap," the incessant announcements are quite helpful.

There are updates on congestion and delays to help us better plan our routes.

There are reminders about weekend track work that will impact some lines.

There are announcements about upcoming train stations, transfer options and key sites at the stop, such as "Change here for the Circle Line" or "Alight here for Buckingham Palace."

As someone unfamiliar with the Tube, I found these extremely helpful — even though we did miss a stop or two, but more because we were chatting.

Remember, in health care, all of our patients and visitors are unfamiliar with navigating their care — and are often in a very vulnerable and frightened state.

So talk more, not less.

Lesson No. 2: Signage at every turn.

I grew up on Boston's MBTA. One thing the T could improve upon is the ratio of informational and directional signage to paid advertisements.

On every Tube train we took, there were easy-to-read line maps. There wasn't one or two per car, there was one everywhere you looked. Sitting, standing, it didn't matter. Just look up and you can see where you are — and where you're going.

London's ratio of ads to informational signage was just right — and that made the paid ads all the more noticeable.

For our patients and visitors, make sure they can find their way easily. And when someone likes confused, take the time to walk them to where they need to be.

Lesson No. 3: When in doubt, communicate.

The London Underground is relatively efficient. You arrive at a station, the doors open, people disembark and others board (after minding the gap), the doors close and the train departs. 

This all takes 30 to 60 seconds.

But when it takes 61 seconds, the staff come on the PA and say something like, "Sorry for the delay. We are experiencing a signal problem and will be underway shortly." Which usually meant less than a minute.

Contrast that with the lack of communication at Heathrow's Terminal 1 and on our US Airways flight back to the states where we endured cumulative delays of more than four hours — delayed gate assignment, delayed departure, delayed landing, delayed arrival gate and many missed connections.

Throughout this process, the airport and airline made very few announcements. And when they did, they had very little information. If they had been totally up-front with us about our delays and our missed connections, everyone would have been happy.

Again, more talk, not less.

All of which gets me to think about how this applies to my world — health care.

Communication and customer service are the chief complaints at most hospitals. It's the wait times. It's the fact we don't always tell patients what to expect or we don't update them enough as to what is actually happening.

A lack of information creates a vacuum. If we don't tell folks what is happening, they will make up their own ideas. And get frustrated. And then get upset. And then tell someone else. And then we have a reputation — and not the good kind.

As we look to improve care and make health care more efficient, let's also make our communication more user-friendly. Let's tell people what they want and need to know — when they need to know it.

And there's one more lesson from the Tube — this one a marketing lesson.

Lesson No. 4: Put your logo in great places!

 

View of House of Parliament from just outside the Westminster station.

Photo shot on iPhone and edited with Photo fx.

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Filed under  //   customer service   health care   hospitals   lessons   London   Tube  

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