Who’s missing from the healthcare reform debate?

By Bruce Stanley

Recently I attended a medical device symposium, where noted speakers lectured on current technical topics. What I found astounding was that it took over four hours before anyone from the distinguished panel even uttered the word “patient.”

This made me think a bit more about our national discussion about healthcare. We hear insurance choice or no choice, high deductible, low cost, high quality, medical device tax, exchanges, technology, contracting compliance, surcharge yes or no. Add this to the Washington, D.C., rhetoric of repeal, replace, skinny repeal.

With the high-level political leaders, large manufacturers, lobbyists and other influential interests controlling the real destiny of healthcare, one must ask, “Do patients even matter anymore?” We’re told that healthcare is one-sixth of the economy, but never does Washington acknowledge that it involves 100 percent of the population. It’s been clear for awhile that healthcare is less about providing care for our citizens and more about health economics.

Circular debate only prolongs bad care
This decade-long debate over the Affordable Care Act and the many proposed replacements only fuels the agonizing debate over what’s good for patients. It’s not always clear if healthcare thought leaders even believe it’s appropriate to bring up patients, let alone discuss how treatments should change. Does a patient or family member care if the system cost is $1 billion or $10 billion? Whether a device is taxed at 2.3 percent, 10 percent or zero percent? We never go to see a doctor and ponder why the medical device tax is so high. We go to be cared for and healed.

Products and services are often designed and developed based on a theory that they will contribute to better care. But has anyone asked patients for their opinions on the financial and clinical value of those products? We test for cost and function in the market, but often with little emphasis on patient understanding and satisfaction. Reimbursement is always an underlying theme.

Current technological innovation is very promising, but it can’t replace one-on-one interactions. We need to remain connected with patients in a more meaningful way — not just by Twitter, Facebook and email. A veteran physician shared with me that when teaching new doctors, she must remind them to look at patients to assess their condition — not to just look at data on their computer screens.

Today many entrepreneurs speak for the patient — but none of them are patients. That said, all of us — no matter what role we play — need to think and feel like patients when designing products, developing strategies and holding discussions on healthcare reform.

How to get patients back into healthcare
Ask a patient what logistics, supply chain or contracting means for their care, and you might get a blank stare. Truth is, every part of our system can be patient-centric in a holistic way. Whether it’s a national group, an insurer, a governmental agency or product line company (the usual suspects), all can be instrumental in the national dialogue on healthcare. Most of all, the real leaders in healthcare are the day-to-day practitioners who must battle not only the disease states of their patients, but the constant barrage of innuendo, platitudes and pontificating from the many areas of our society weighing in on healthcare.

Here’s a first step: Every time we invent or discover, implement, or just talk about healthcare, we ask how will patients feel about it? What will patients understand? How does this affect the care of patients? Clearly the future of personalized care using new care technologies may be on the horizon. Patient groups need to do their part to become more actively involved not only in the debate, but in actual product design and implementation.

We should challenge everything we do in our industry. In this way, we might find stronger value statements with real purpose and ones that affect patients in a more meaningful way. Let’s start a robust dialogue around patient care, and begin designing new technology, payment schemes and long-term effective care always with the “Patient first.”


Bruce Stanley is a supply chain and contracting operations consultant, and an adjunct professor at Endicott College’s MBA program, teaching global supply chain, contracting and healthcare informatics and regulations. In 2011, he co-founded The Stanley East Consulting Group, in Ipswich, Mass., a consulting practice specializing in supply chain, contracting, order fulfillment and project management for small and medium-sized companies, startups, and companies in transition or divestiture. Earlier, he served as senior director, contracting operations, for Becton Dickinson.

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