|
|
(HealthNewsDigest.com) – If there was ever a doubt the U.S. healthcare system has been hijacked by bureaucracy, consider this: With data from the Bureau of Labor Statistics (BLS), the National Center for Health Statistics and the United States Census Bureau’s Current Population Survey, Physicians for a National Health Program determined that between 1975 and 2010, while the number of doctors in the United States grew 150 percent, the number of healthcare administrators increased 3,200 percent. With such tremendous proliferation, one would assume there must be good reason for so many administrators in the U.S. system. Among proponents, the University of Scranton website builds a strong case, not only explaining the driving factors but also encouraging individuals to pursue a career in a field that’s booming:
“People are sometimes surprised by the sheer size of the hospital economy in the United States. In its annual survey, the American Hospital Association records a total of 5,686 hospitals in the U.S, of which about half are not-for-profit community hospitals. While these numbers might not be particularly impressive, data on the accessibility and use of these hospitals shows the increasing need for hospital administrator jobs. In all these hospitals, there are 914,513 staffed beds. Each year, people are admitted to U.S. hospitals over 35 million times. The expenses for all U.S. hospitals total about $859 billion, which explains the pressure on hospital administration to make processes more efficient and eliminate unnecessary waste.”
With information from the BLS, the university points to aging Baby Boomers, who will undoubtedly require more care, to underscore the critical need for more “trained healthcare administrators to streamline processes and manage daily functions so that medical staff can meet the higher demand for preventive care and treatment.”
How is that working for the U.S.?
Despite the fact that from 1990 to 2012 the U.S. healthcare workforce grew by 75 percent, and the ratio of doctors to other healthcare workers is now 1:16 as opposed to two decades ago when it was 1:14, Healthline reports only six of those 16 are nurses and health aids are directly involved in caring for patients—while the other 10 are in purely administrative roles. Those numbers, uncovered by a Harvard Business Review (HBR) blogger, are not a result of increased patient demand but rather the increasing bureaucracy that has become the norm in the U.S. healthcare system. In the Healthline report, executive vice president of the Institute for Healthcare Improvement (IHI) Jeffrey D. Selberg goes on the record, stating:
“There’s just more and more layers of stuff that hospitals and physicians’ offices—anyone in healthcare—is being asked to do. Documenting and meeting regulatory requirements—all of these have added to the demand,” he said. “Has that demand actually gone into creating better outcomes…in less time and with lower costs? I think, as the blog described, the answer is no.”
He’s not alone.
Most experts would agree that bureaucracy is precisely what’s keeping the U.S. healthcare system from getting better. In a recent HBR article chronicling the results of growing bureaucracy across a wide range of industries, the authors determine among other things that bureaucracy is the enemy of speed. And in healthcare, that can be a matter of life and death. In 2015, CNN reported that 307,000 veterans died waiting for care. In November 2016, an Illinois Department of Human Services report confirmed that 752 Illinois Medicaid enrollees died while waiting for approved medical care. In 2017, a report was released by the Veteran’s Administration inspector general revealing that almost 100 patients died waiting for care in Los Angeles, with 43 percent of the patients dying while waiting for appointments. But that’s a small sampling of what’s really happening in the U.S.—and a subjective perspective at that. Across the pond, the sentiment is surprising, considering that the nationalized healthcare system in the United Kingdom (UK) has long been subject to criticism in the U.S. for its inefficiency.
Mary O’Hara, an award-winning social affairs writer and author of “Austerity Bites: A journey to the sharp end of cuts in the UK,” gives an outsider’s point of view in The Guardian. Winner of the International Columnist of the Year at the 2017 LA Press Club Awards for her “Lesson from America” column, she writes:
“The idea that private systems mean greater efficiency is simply unconvincing. I have pretty good US health insurance and yet the shortest waiting time to see my designated doctor has been five weeks—much worse than under the NHS.”
But Mary isn’t necessarily out to defend her homeland; in her experiences, she has observed that when sick or needing care, wait times for appointments in the U.S. are longer than in the UK:
“There have been many trips to see the doctor over the past year that I have lived in Los Angeles, but I’ve never managed to get an appointment with the US equivalent of my GP when I needed it, instead being directed to the equivalent of a locum. The shortest waiting time offered to see my designated doctor was five weeks. Otherwise it’s been over two months. And that’s after I’ve forked out hundreds of dollars every month in insurance premiums—plus up-front cash fees equivalent to £20 and £35 for each visit and referral.”
But don’t take her word for it; there is plenty of evidence to suggest that bureaucracy in the U.S. healthcare system is killing us. The results of a study published in the Annals of Internal Medicine reveal that doctors spend approximately two-thirds of their professional time on arduous amounts of non-clinical activities. From fulfilling EMR (Electronic Medical Records) and EHR (Electronic Health Records) requirements to negotiating with insurers for specific test and diagnostic approvals, these mandatory tasks leave doctors with little time—less than a third—to engage directly with patients.
So much for streamlining processes and managing daily functions so that medical staff can meet the higher demand for preventive care and treatment.
There is a growing consensus that entrepreneurs are more likely to help solve the problems and challenges in the U.S. healthcare system than those held hostage within it. It’s worth a shot to let them try, because it’s only a matter of when, collectively, we have had all we can take.
ABOUT ROBERT E. GRANT:
Robert E. Grant is founder and chief executive officer of CONCIERGE KEY Health, a premier healthcare service that provides on-demand access to top-tier doctor specialists, an assigned healthcare team, dramatic reductions in wait times and the ability to schedule an appointment with the click of a button. An entrepreneur, inventor and investor, he has played a pivotal role for more than 20 years in successful technology and business development in pharmaceutical, medical device and healthcare markets. In addition to founding CONCIERGE KEY, Grant is founder and vice chairman of ALPHAEON Corporation, as well as founder, chairman and managing partner of its parent company, Strathspey Crown Holdings, LLC. Most recently, Grant was CEO and president of Bausch+Lomb Surgical, leading the significant growth of its product portfolio. From 2006 to 2010, he served as president of Allergan Medical, leading the $3.2 billion Inamed acquisition and the commercial success of the Botox Cosmetic, Juvederm, Natrelle breast implants and Lap-Band brands. Grant also served as director, board chairman, CEO, president, COO and CFO of Biolase Technology from 2003 to 2006 after holding various senior management positions at Lumenis for six years.
An independent director on several corporate boards including Acufocus, Myoscience and ReShape, Grant has served on several community and civil boards including Make-A-Wish Foundation, Young Presidents Organization, University of California, Irvine (UCI) CEO Roundtable Steering Committee, Chapman Schmid College and both UCI’s school of law and Henry Samueli School of Engineering. Grant received his bachelor’s degree from Brigham Young University and graduated with honors from Thunderbird School of Global Management, where he earned his MBA. He has also attended the President’s Seminar at Harvard Business School and has lived and worked in nine countries, with fluency in Japanese, French, Korean and German.