Michael Porter had an idea: not a smart idea, but a common sense idea, and it is spreading. Value-based healthcare now has its own prize. It is about measured value for the patient divided through the costs, and healthcare economists are applauding: when your vision is scarcity, how better divide it then to give it to what gives value most.
Not everyone is aware about it, but doctors and patients can sense that healthcare is about the technical content in the last place. What actually is valued most are the not-measurable human and relationship factors. Like it is said: The patient doesn’t care what the doctor knows, until the patient knows that the doctor cares. When the patient doesn’t trust the doctor, when the doctor is not listening to the patient, no real value can be created. Do you get stressed, because these human factors cannot be measured? I have good news for you: they also don’t cost a thing! They are not scarce, they only need space. Unfortunately, it is patient-doctor time value-based healthcare tries to bring back to the absolute minimum. To my opinion leading to a decreasing-value-based healthcare.
Most patients don’t suffer from what they consciously call their primary complaint. Most patients don’t present themselves with a textbook disorder. Healthcare starts with understanding what’s wrong with the patient. Who will be able to do that when all doctors work in one disorder-specialised teams? Diagnostics asks much more than what our minds learned at medical school. Without a thorough human understanding of the patient every intervention should be withhold.
But we can always start with being present with the patient, listening, observing, showing we care. The healing process starts with that.
Healthcare doesn’t need more ideas. Healthcare needs to start feeling what is necessary and to put that in words. Then we can return from value-based healthcare to healthcare again.