It was early evening when the plane touched down on the sun kissed tarmac in Seattle. A rag tag bunch of clinicians and managers from around Hampshire embarked on the trip in order to learn from the US healthcare system.
We were visiting Kaiser Permanente, an acclaimed healthcare organisation in the US, and Microsoft, on a fact finding mission.
Our group was made up of staff from four different organisations. Organised by the charismatic CEO of one organisation, was this a genuine trip to learn, was this a trip to work together to improve the local health economy, or was it simply an elaborate publicity gig to convince us about the role of competition and being the best competitor?
So we toured the cities of Seattle and San Francisco. Got dazzled by the technology in Microsoft, and looked in awe at the potential of the prototypes of IT in development.
We went to different healthcare organisations and visited Kaiser Permanente, and ended up being very grateful for being asked to be part of this trip.
Three things stood out for me. One, the challenges are similar across the pond and we, in the NHS, have much to be proud of. We do so much more than what our system can provide and the NHS will continue to survive on the cocktail of hard work, passion and commitment.
Secondly, I saw an IT system to die for. The NHS spent billions trying to create an IT system and frankly failed. What we saw was a clinicians dream. It didn?t matter where any healthcare professional worked, it didn?t matter who the patient saw?it was all there - one IT system. To us, it sounds like a dream, to the professionals working in San Francisco, it?s a way of life.
And, finally, there were clinical lessons. They ?target? patients with multiple morbidity, give them more time, and have more faith in their community nurses.
However, the big issue was their use of ?performance management?. Frankly it was amazing to see doctors willing to be measured against predefined criteria. Somehow in the UK we spend more time defending ourselves as doctors rather than accepting that some of us do not serve our patients well.
Any criticism of general practice is met by evangelical resistance from RCGP chief Clare Gerada and others. At no point is there acceptance that things may need to change, not all apples are perfect.
And the same is true of specialists; we are all doing a ?fabulous? job! Really? All of us, without exception? Do please behave! We should not be making the patient bend to our own lives or its comfort. We do this job as public servants trying to help those who need it. Are we ready for ourselves to be measured against that?
I asked what happened if doctors weren?t compliant or were failing persistently. ?We try reasoning, then we ask them to leave. You can?t continue if you are not serving the patient,? said the Chief of Medicine with a gentle yet firm smile.
How many GPs or consultants in the NHS are even measured, let alone asked to ?move on? because they couldn?t deliver clinical based outcomes? Can patients walk into a clinic and see the performance results of each doctor?
We are far, far behind that. We would rather state how incredibly hard we all work and how difficult the patients make our lives and how we need more resources. The NHS continues to carry dead wood.
It was a joy to have been a part of this trip. I learnt a lot about healthcare, I learnt what we could do better; but, most importantly, I walked away making a lot of similarly minded, passionate friends.
Now for the tougher part: Can we make this all work? Can we battle the tide and have a sustainable health economy? Can we keep these relationships going to work together and somehow make it happen? We can but try.
Read more at Partha Kar?s?personal blog.
Tags: US healthcare
Source: http://www.hospitaldr.co.uk/blogs/partha-kar/healthcare-lessons-from-across-the-pond
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