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.