In order to deliver healthcare for all, we need to reevaluate the ‘gold standard’ of healthcare delivery and look to new models of care.
This was the message of a talk a few of us from Wellpepper attended last week given by Dr Jason Hwang. Dr Hwang is an MD and also an MBA who collaborated with Harvard professor Clayton Christensen on the book “The Innovator’s Prescription: A Disruptive Solution for Health Care.“
Dr. Hwang used the familiar story of disruption in technology from the mainframe to the PC and now smart phone to draw analogies between the current state of healthcare, and where it needs to go. He calls hospitals the “mainframes” of the healthcare system. Highly powerful, capable of delivering great output, but not necessarily convenient or accessible, just like mainframes used to be. Consumer clinics, for example a nurse practitioner working out of a storefront in Walmart can be seen to be more similar to the convenience of a smart phone. However, the industry hasn’t changed processes and regulations to accommodate these new models causing unnecessary overhead and barriers. Does a storefront clinic with no doctors need the same levels of documentation and EMR as a hospital?
Disruption makes what was once inaccessible more accessible, and eventually delivers it into the hands of consumers. The ridiculously powerful computer that 50% of us have in our pocket or purse is the perfect example of that. This computer is also democratizing healthcare. There are approximately 17,000 medical applications that enable consumers to track and sometimes even diagnose health issues that previously required visits to specialists.
Any doctor that can be replaced by a computer deserves to be. The idea is not to replace doctors but to free them up to do the work they were trained to do.
The same could be said of specialist and generalist roles in healthcare. Nurse practitioners can take on a lot of responsibilities that were previously tasks of doctors. Medical aides can take responsibilities from nurses. Advances in technology are helping to make expensive diagnostic tools cheaper and more ubiquitous.
What does all this mean for physical therapists? Dr. Hwang stressed that it’s very difficult for those within the system to disrupt it. For example, once a hospital exists there become all types of reasons for it to continue to exist: shareholders, board of directors, senior management, employees. It’s very hard for a company to cannibalize itself. He believes that those in the wellness, prevention, health and fitness industries have a greater opportunity to cause this disruption. Physical therapists have the unique position of being within the industry but not at the center of “how things have been done.” As they move into looking at the whole health of the patient, and more important in preventing injuries, they can be part of this change in medicine.
An interesting example of this is physical therapy combined with other health and wellness; for example, a clinic that has an MD, naturopath, nutritionist, and physical therapy practice, or a “medical gym” which combines a physical therapy practice with a traditional fitness center. This would be the perfect place to practice preventative medicine.
We’ve seen a lot of chat on Twitter about how physical therapy can be part of the positive disruption that’s happening in healthcare. At Wellpepper hoping we can help you move forward new models for patient engagement and involvement.