An academy for healthcare leaders could be exactly what the doctors envisioned.
Those who follow my reflections know of my deep belief that our broken healthcare system is the result of a leadership crisis in American healthcare. We are saddled with inauthenticity, poor execution, and incomplete consideration of the tradeoffs required to build and run systems that rein in costs while improving patient outcomes.
One of the problems with healthcare leadership is that it too often fails to grapple with ethical challenges. Financial success and virtue are pitted against each other; all too often the first one comes out on top.
Lately, I’ve been fantasizing about solving these problems by building an academy to train today’s next generation of principled healthcare leaders. In those fantasies I bought some land in Westchester County, New York. It’s hard to see from the air, and you’d never notice it if you walked past it. But look behind the trees and the rugged landscape and inside you’ll find what I call, with apologies to Marvel, The Xavier School for Healthcare Leaders.
Here’s a look at some of the course offerings designed to train industry leaders capable of creating a humane, affordable, accessible and equitable healthcare system that balances financial incentives with patient needs.
Patient Care 200: The Lived Experience
“If you’re going to change something, you need to know something,” a colleague of mine always said. SCAN, the diversified healthcare organization that I lead, used to have a program called Trade eras; through high-tech headsets, people could gain first-hand insight into the aging process. Likewise, this course will rely on low-tech solutions to create empathy for people dealing with common diseases. The students wear glasses smeared with Vaseline to get a sense of what it’s like to have cataracts, and noise-canceling headphones to better understand what hearing loss feels like. During an excursion, participants go shopping with a walker and try to access public transport while in a wheelchair. During the final exam, participants eat five super-sized fast food meals in 30 minutes and ride a roller coaster, so they get an idea of what polypharmacy often feels that way.
IRVINE, CA – APRIL 04: John Downing, a senior advocate at Scan Health Plan, tries one … [+]
Engineering 300: Navigating the Healthcare System
In this practice-oriented course, students work as care navigators within a real health plan. They take members’ calls during a week-long shift and help them access care, refill prescriptions, schedule appointments with specialists, arrange transportation to and from appointments, deliver results from their lab to various offices of to enable healthcare providers to fax and understand their care regimens. Students wishing to pursue advanced study in this subject will need to demonstrate their ability to explain deductibles and co-payments in plain language.
Healthcare Economics 200: The Freedom to Capitulate
Too many physician groups and healthcare systems are reluctant to accept risks to their patients’ health outcomes by adopting global capitation arrangements. But in this course we will learn that, as my mentor Leeba Lessin used to say, “capitation is freedom.” Often, provider organizations complain that payers stand in their way by relentlessly focusing on costs. But by entering into capitated care agreements, providers can find the foundation to dictate the trajectory of care while focusing more on outcomes. Designed for the skeptic, this course provides participants with many examples of healthcare providers who have built successful and lucrative practices while achieving patient results that put their peers to shame.
Healthcare Economics 310 – also called “Follow the Money.”
No one can effectively change—let alone simply maintain—the status quo of our health care system without a rudimentary understanding of its economics. In this lesson, we’ll follow healthcare financing and learn how money flows between private and public payers, providers, pharmaceutical companies, and the countless other participants in the healthcare system. Courses will focus on misaligned incentives, where individuals and companies are paid handsomely for producing consistently inferior results.
Patient Care 330: Medication Adherence
Almost everyone who enters a healthcare profession thinks that the easiest way to treat a patient is to prescribe medications. They don’t know that patients only take their prescribed medications half the time. In fact, noncompliance likely causes 125,000 deaths and a quarter of all hospitalizations in the United States. In this course, students will learn the causes of non-compliance, with an emphasis on the causes that are financial and cultural in nature. To pass the course, students must demonstrate skills that increase medication adherence, which takes time, money, hard work, cultural sensitivity, and most importantly, patience. Please note: It is likely that many students will come into this course thinking it is an ‘easy A’, fail and be asked to take the course again and again. Just like doctors do every day.
Only a fraction of patients ever take medications as prescribed – a fact that many healthcare leaders overlook.
Executive Management 420: The Role of Risk
This course, not to be confused with Healthcare Economics 310 above, focuses on the value of risk in management. The premise of this class is that too many healthcare leaders are risk averse. They believe in slow incrementalism, conducting endless pilots and studies, and seeking elusive consensus before implementing common sense solutions. In this lesson we will learn how to quickly implement change and inject innovation into systems before resistance to it takes shape. Special emphasis will be placed on learning from mistakes and repeatedly improving bold programs and initiatives.
Being human 101
Compulsory for all diploma candidates. No matter what you hear, the future of healthcare – like the future of most industries – will depend on artificial intelligence. AI systems scan medical records, read images, make diagnoses, make treatment recommendations, discover the most effective treatments, and much more. This means that the best healthcare providers of the future will bring a human touch to patient care, something that computers simply cannot do. In this lesson we will learn how to speak in plain language, ask questions in a sympathetic manner, and show a genuine sense of caring. Successful candidates will learn that human connections in healthcare do what computers, diagnostics and treatment plans cannot.
Genuine care, concern and compassion for patients will never go out of style – and it will stay that way … [+]
Admission criteria for all courses
An expressed desire to improve healthcare for patients. Applicants who focus excessively on profits or policymaking and tinker procedurally for their own good are strongly discouraged from applying.
All of this is meant to be ironic – or is it? What would our industry look like if we had an academy – and anyone who wanted to drive change – management, politicians, board members, investors – had to demonstrate these basic skills. I suspect we are much further along the path to the health care system we want and need.
