Joe and I recently attended the September 12, 2013 Healthcare Enterprises Network event, “A Path Forward for Providers in the Era of Health Care Reform: Lessons from Massachusetts,” by Thomas H. Lee, MD who was a part of the Massachusetts Health Care Reform Act passed in April 2006.
Dr. Lee started with how the MA Health Reform Act unfolded, discussing contentious issues like employer penalties, funding concerns, the state budget crisis, shared risk, payer models, etc.
“We learned a lot,” he said, and then built a relational discussion about care redesign based on what was learned, which involved access to care, design of care and its measurement. He considered what was important to the patient, the power of value-based care as a proactive resurgence to quality and cost minimization. After all, it wasn’t rocket science, or even necessarily revolutionary; just practical solutions to shield against the finite healthcare pool and the well-meaning care givers and circuitous systems through which we find ourselves navigating. There were no “magic bullets,” he said.
But Joe and I were suddenly struck with the unexpected next which seeped into the second level of consciousness like the smell of hot chili in a hallway—Take the emotion out of healthcare. Now Dr. Lee wasn’t personally advocating this, only stating it as a hypothetical physician rule, an old school directive, a survival of choice in the surrounds of stacked up sickness. Not that physicians were wrong to choose such a stance when delivering the care they knew best, when surviving the best of what they could give was offering the knowledge of medicine from the distance of the heart.
But patients are afraid, Dr. Lee said, with clarity of realness, his moderate frame filled with the giant of his ideas, the metamorphoses of strategic simplicity: “Improve value for patients; improve the outcomes that matter to patients versus the costs required to deliver those services,” he said with emphatic pause. “Reduce suffering and do it as efficiently as possible.”
And then the patient value will come. Cost savings to follow?
But what’s in the design of de-“sufferization”? How to deconstruct the fear, the anxiety, the deleterious sounds of the symptoms of suffering from the honesty of bad news, the slather of hopelessness, an unstoppable mind pinging loud with the bell which tolls that sickness is near?
Deliberate intent to deconstruct the hurt was his most avid point, at least to me. And we were listening, compelled to be there by the pull of an unknown tug, looking for knowledge, always seeking answers to the convulsing healthcare landscape that shakes daily around us. And there was a solution, right in our own back yard.
We realized we were nearer to this concept of defiance because within our walls was a calibrated melody of the spiritual as an intervention of healing. Even early on as we created and built our spiritual model, we saw residents finishing their prescribed therapy because they were encouraged by a spiritual quality, an essence of empowerment that reached into their state of loneliness and sorrow of condition, and belief in the resurgence of faith that wellness mattered and change of condition was possible. Depression around circumstance, we found, could circumvent healing. Remembrance and reminders of why they mattered, prayer in the ethereal of the tangible of faith’s presence began to infuse the possible into the physical of the outcome.
Our model: Spiritual inputs for optimized outcome, offering the support of prayer, the hope in the Divine, the power of comfort in the belief and practice traditions of a particular faith, and integrating that with the prescription of our care. Our brave new world idea was suddenly a practical one.
And Dr. Lee knew this, and when Joe and I went up to meet him after the speech, he knew us. And we were amazed that the outside world of quality and measures was looking at us, peering inside at our own attempt to defy the anguish of fear and unleash the Dunamis power of reconstructed hope.
Dianne Timmering, Vice President of Spirituality, Signature HealthCARE
“The only true measures of quality are the outcomes that matter to patients.” Harvard Business Review, The Strategy That Will Fix Health Care, by Michael E. Porter and Thomas H. Lee
Dianne H. Timmering 