Airline standardization vs. healthcare craftsmanship: a short comment

Recently, Eric Just published a post in HealthcareITnews making an interesting analogy / contrast between the airline industry and healthcare industry. If you are as surprised as I was when first going through the title and the first few lines of text, don’t worry; my guess is that it was an intentional attention-grabber (that happens to work). In any case, the essence of the post is his observation that while we do have lots and lots of advertisements for individual physicians we do not see individual pilots competing in the same way. While we entrust both the pilot and the doctor with our lives, we do not routinely seek individual pilot credentials. The fundamental issue here, Mr. Just continues, is the fact that strict airline guidelines, protocols, procedures - in other words standardization - ensures that we do not need such information. The reverse however holds true for the medical profession: there is huge variation in the way it is practiced and a huge - and not always correlated - variation in pricing.

The analogy itself is instructive even if (obviously!) one should not stretch it beyond its limits. I am especially reminded of the last year Senate hearings that spoke of more than 1000 people daily (read this again: daily!) dying from preventable medical errors. That is between 200.000 to 400.000 (depending on the methodology) unnecessary deaths in US can be attributed to the healthcare system itself. This can be just big numbers until you put in its proper perspective. Peter Pronovost, MD, who is the senior vice president for Patient Safety and Quality and director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins, put it this way "What these numbers say is that every day, a [Boeing] 747, two of them are crashing. Every two months, 9/11 is occurring…we would not tolerate that degree of preventable harm in any other forum." It is a mark of our times that a 9/11 generated a war (or several wars, you choose) the cost of which is estimated be at least 1.6 trillion US dollars so far, while the six 9/11s we get each year from medical errors is simply... unnoticed. I simply cannot decide which is more chilling: the number of preventable deaths or the public lack of reaction to it.

Coming back to the issue of standardization vs. craftsmanship you can see by the end of the post what is it that the author is suggesting as a solution. In a nutshell: determine best practice standards, implement a system to enforce or encourage them and then do some big data analytics to discover what works and what doesn’t. If you ask me, after it’s great start the post is a letdown. Mainly because the solution brought to the table is, how to put it?, old news. Essentially the solution offered again and again is imposed from the top on all the end-users of the healthcare system.

At Cashdoctor we argue that we need a bottom-up solution as well. For the past three decades the healthcare industry has been controlled by doctors, hospitals and large corporations. During this time the cost of healthcare has gone through the roof. It is our MISSION at CashDoctor® to return health care to the PEOPLE and reduce the cost making it affordable for all. In order to do this, the PEOPLE must come forward and provide the missing link for a REAL health care revolution to take place - PRICES (actual cost of specific procedures provided by specific providers in specific areas) and RATINGS (actual experiences by actual people).

Notice how all three elements mentioned by Mr. Just can be implemented in this bottom-up approach?

By sharing this information with virtually everyone via the CashDoctor® website and social media tools we are currently developing, we can put the healthcare industry on its HEAD and you just might save someone’s life in doing so. We saw the Arab Spring bring down governments, we have seen Occupy Wall Street grab global attention, now we are about to launch the "SHARE HEALTH CARE" movement.