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  • Health & Wellness

    Smart Ideas for Reviving American Health Care

    By Tracy Mueller
    Published: April 28, 2014

    health care delivery solutions

    How can organizations managed by such smart people operate so poorly?

    That’s the question that hounds Reuben McDaniel when he wakes up and it’s what drives him each day. Target number one of his frustration: the health care industry.

    “It’s a crisis,” he says, noting that American health care costs too much (it’s the number-one cause of personal bankruptcy), isn’t of consistently high quality (preventable medical errors in hospitals kill more people than motor-vehicle wrecks, breast cancer and AIDS) and isn’t equally accessible to all.

    But McDaniel, professor in health care management at the McCombs School of Business, is optimistic about the possibility for change in the near, if not immediate, future.

    “We can do something about improving health care delivery in five years. Cancer could take 20 years,” he says.

    McDaniel’s vision centers around institutions and individuals working together, which he says is the key to improving quality.

    “You think you want the best surgeon,” he says. “But what you really want is the surgical team that has the best relationships among each other.”

    (Related: School of Nursing wins $1.2 million grant to implement interprofessional team education.)

    McDaniel’s research into how health care teams work together has revealed that the way doctors, nurses and other providers relate to each other directly correlates with the quality of patient care. (Most prior research in the area focused solely on the patient-physician relationship.)

    His research has also shown that electronic medical records in their current design aren’t as useful in helping to solve problems as they could be, and that needs to change. He also wants to see changes in the way physicians are paid, more efficiency in the ways hospitals are run and improvements in how patients are involved in their own healing.

    (Related: Moody College of Communication researchers on a mission to improve health literacy and enable people to make informed decisions about their health.)

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    McDaniel says a good place to start with these types of changes: medical education.

    Dell Medical School has a huge opportunity to make improving health care delivery part of its program,” McDaniel says of the new University of Texas at Austin medical school, scheduled to admit its first class in 2016. “We can choose to produce doctors who view their role differently.”

    (Subscribe to the Dell Medical School e-newsletter.)

    Dr. Clay Johnston, dean of the medical school, couldn’t agree more.

    “Medicine is a bad business. It works, but it’s built on a foundation that needs a reexamination,” Johnston said in a video interview earlier this year.

    Johnston pointed out the need for care providers to embrace technology and work together in teams.

    And while new systems often come with extra dollar signs attached, Johnston says a lot of these changes will help reduce cost. “They’re things that will actually cost less, make patients happier and deliver better health care,” Johnston says.

    McDaniel agrees, dismissing the notion that innovation will bankrupt an already cash-strapped health care system. “There’s plenty of money in the system,” McDaniel says. “The problem is how it’s distributed.”

    Every year the McCombs School of Business Healthcare Initiative hosts the Health Care Symposium, bringing together, bringing together a community of practitioners, administrators and researchers to discuss improving health care delivery. We gathered a few tweets from this year’s event to see what scholars and industry experts are talking about.





    In Pursuit of Health graphic

    This story is part of our yearlong series “In Pursuit of Health,” covering medical news and research happening across the university.

    • Quote 2
      Victoria Bradley said on May 10, 2014 at 1:13 p.m.
      Dr. Clay Johnston makes a good point. As a country, we need to refocus our medical system to be more about the patients than profits. By integrating technology, we can make the system better for patients because they will be taken care of in a way that seems more personal and more caring. Patients should not be disconnected from their healthcare, but should feel like they play an integral role in their treatments. But there is a downside to enhancing the relationship between doctors and patients: although a patient may have a higher level of satisfaction with their healthcare, overall their care can actually be compromised because patients become too trusting and can be taken advantage of. Additionally, patients may be reluctant to report malpractice if they have a strong relationship with their doctor because they will not want their "friend" to get into any trouble. We need to find a balance between the social and the distant aspects of healthcare to ensure that Americans get the best care. Even though this is definitely an area that will bring some improvement, we need many other drastic changes to our healthcare system to get it up to the standards that we deserve. Citizens should not be at risk of personal bankruptcy when attending to their health needs; citizens should be able to get all of the care to which they are entitled. We need to make a change in this country to make healthcare a right rather than a privilege. In the U.S., we spend far more per capita on healthcare using public tax dollars than countries with entirely socialized medicine and get no healthcare in return. Our care and procedures are outrageously expensive, and reform could change that. Americans are clearly unhappy with their healthcare system, so it is time that we finally do something to fix what is broken. I ask that you watch the two linked videos. One is about the healthcare system in France, a system that is the envy of many other countries. The U.S. could learn something from their system. The second video explains the complicated reasons why healthcare is so expensive in America relative to other countries. More Americans should be informed of the alternatives so that we do not have to be stuck with our current system.
    • Quote 2
      Bill Storrer said on May 9, 2014 at 8:51 a.m.
      At a Harvard symposium in the 1980s a doctor showed the mechanism of how cancer enters a cell. Plugging the entry would eliminate cancer. So, why are we decades later still having no solution for cancer? The solution should be obvious. In China many pay a doctor while they are healthy. They stop payment when they get sick. We might try this. Obamacare is the best we could get given that certain politicians demand that someone must make a profit out of healthcare. Get rid of profit in healthcare (and education) and costs would fall.
    • Quote 2
      Dana said on May 7, 2014 at 10:37 a.m.
      Here's an idea, although certainly not a novel one. Medical professionals should ask for feedback, like most other businesses, and actually use it to improve their services. Every time I have an encounter with a health care professional, I can tell you several things that were done poorly. But, they never ask. Ignorance is bliss, I suppose.
    • Quote 2
      Barbara Wand James said on May 1, 2014 at 8:11 a.m.
      The medical system is a complete mess. Any time profit and healthcare are conjoined, problems will abound. I have been dealing with a medical issue recently that could have been handled by a risky, expensive surgery but I chose a less invasive treatment administered through a functional neurologist. I am happy to say that I am making great progress and expect full recovery from something that, according to most "reliable" internet sources, most people never recover from. Western medicine has been reluctant to treat people as holistic beings. Sadly, many doctors know nothing about nutrition, meditation, chiropractic care, or other types of healing--they are quick to prescribe a pill and/or surgery without ever getting to the root of the problem. When asked about alternative medicine, or foods or supplements that might help, they usually shrug their shoulders and make the patient feel like s/he is looney-tunes for even bringing up such nonsense. When I broke my arm in three places a few years ago, the doctor who treated me wanted to load me up on pain pills, which I refused. He also told me there were no supplements or foods that would help me, AND, that I was highly likely to have arthritis at the three break points. Lucky for me I didn't believe any of that and found a great website that gave me suggestions for nutritional supplements I could take and physical therapy exercises I could do prior to even starting prescribed PT. Fortunately, I healed much faster and better than the doctor had predicted. He was surprised to see the final X-ray showing no signs of arthritis. When I told him what I had done, he blew it off and basically said I was very lucky. Luck had nothing to do with my excellent recovery! Until doctors realize they are mere mortals, just like the rest of us, and that the doctor-patient relationship should be one where they learn from each other, not where one is the dictator, our medical system will continue to be ineffectual. I wish Dr. Johnson all the best as he begins to design an innovative approach to medical school. Hopefully he will take the best that Western medicine has to offer and integrate it with more non-traditional approaches to healthcare that have also been found to be effective.
    • Quote 2
      Helen said on April 29, 2014 at 1:17 p.m.
      My parents (separately) died in a small town hospital of things that shouldn't have happened. That was several decades ago. Now my friend is seriously ill, after treatment in one of our biggest "best" hospitals, of things that (I think) shouldn't have happened. [People should not need extended stays for infections that they didn't have when they came to the hospital!]
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