Saturday, November 17, 2012
Saving by Spending
As I think I have mentioned before, I came to realize early
in my career that everything I did to improve efficiency in the hospital cost
more money. Managers and doctors would justify things they wanted to do on the
grounds that they would reduce cost, but when it came time to implement them,
they seemed always to require a budget increase somewhere without an offsetting
decrease somewhere else.
Apparently, things haven’t changed all that much. According to an article in the November 12
issue of the Omaha World Herald, (copied from the Raleigh, NC News and
Observer), “….the federal government is offering as much as $22.5 billion in
incentives for adopting computerized patient records – up to $63,750 per
doctor.”
All of this, of course, is an attempt to make the provision
of health care more efficient by spending more money.
After a few such experiences, I concluded that we in health
care were going about it in the wrong way.
We were trying to improve things without disturbing the underlying
culture and basic structure of the health care establishment and there doesn’t
seem to be any way of doing that. There
are investments that make it possible to reduce cost, but they all involve
changes that affect somebody adversely.
It’s a truth we still haven’t accepted in health care and so
we continue to think we can reduce cost by spending money.