Defining the Goal

The first step in solving any problem is to define a proper goal. This is as true in training horses as it is in delivering health care.

In the case of training horses, the rider has the opportunity – each and every time he works with the horse – to prolong the horse’s soundness, improve its balance, suppleness and straightness or move deliberately toward one of many other goals. Even a pleasure ride should transcend the rider’s self-concern and benefit the horse.

For all the expertise we’ve developed over the centuries in the equestrian arts, we seem to have painted ourselves into a corner relative to health care. My suspicion is that narrow goals, such as tweaking payment systems, broadening access and maximizing profits have distracted us for far too long from the central, overarching goal of improving value for patients.

Were we handling the health care system like a riding master would the horses under his care, we would see daily progress toward the maximization of value for patients. The trend would be toward improving patient outcomes with an accompanying decrease in costs, not the reverse as has been the case for decades in the United States.

As far as I can tell, this goal – the need to improve improving value for patients – is understood by key stakeholders in the health care industry. And now that they’re beginning to understand how to gather the data, I am convinced that they will have an opportunity to make major strides toward this important, but long-overlooked goal.

If the riding masters achieved what they did in their field by reasoning that “quintessence of horsemanship is always to place the interest of the horse above all other considerations” as Dr. Thomas Ritter once said, then it makes sense that health care will become a better value proposition whenever and wherever its providers see that the quintessence of health care is always to place the interest of the patient above all other considerations.

3 thoughts on “Defining the Goal

  1. Steve V

    Thank you for your clear articulation of the goal of healthcare. As first things are put first order and refinement are results. I am further inspired to play my part in this movement.


  2. Coco

    This premise is an excellent place to begin the change that we are in such dire need of making. I feel as a consumer we have the responsibility to make needed changes as well. When requesting assistance for an technical issue from your Internet provider before you actually talk to a technician they require that you do some self tests first. Perhaps there are measures we can do to help ourselves before seeing a doctor. I read the number of doctor visits and subsequent prescriptions that occur each year for the common cold, it was astronomical! The article’s point was even the doctors admitted that it was of no value to the patient. The consumer too must value our resources and be knowledgable about the self care they are responsible for. Just reining in the indiscriminate use of over the counter pain medicine and antibiotics would significantly change the present outcome.


  3. CW

    The financial aspect of the Health Care Industry is based on “Fee For Service” where a health care provider is reimbursed on procedures, services and visits. Doing more of these things increases revenue. This can work against the overall goal of making people healthier because the most profitable patient is the one who has the most services and procedures. One concept that is starting to be implemented is the Accountable Care Organization where a health care provider is paid a flat rate and is incentivized to improve the overall outcome of a patients health. The provider can then look for ways that will improve a patient’s health that costs the least and are no longer rewarded for providing more services. This begins to align a provider to their ultimate goal which is to help a patient become healthier and can begin to bring down the sky rocketing costs of providing health care in this country.


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