In the comments of my post, “Do Doctors Care About the Triple Aim?”, Dr. Randall Oates, Founder of SOAPware offers his perspective on the provider discontent we see growing:
What you say is true and largely explains the growing discontent of physicians. Multiple surveys reveal that at least 40% of physicians are not just unhappy, but manifest symptoms of burn-out. Most of them have become complicit with systems where everyone is more focused on how to get paid more. The few healthcare delivery systems achieving on the Triple Aim and who have better physician satisfaction have almost all been blessed with physician leaders who step up to the challenge of collaboratively creating the necessary cultures focused on delivering value to patients. Value = Quality/Cost. This focus is necessary in order to produce not only the highest satisfaction but the greater financial rewards going forward. Again, doctors not operating at the top of their license and who have become distracted data drones are complicit with an increasingly corrupt system. The vast majority of physicians view that being able to be part of a quality process is more satisfying than the income received. So, those that are the happiest, and thriving the most are ones who are on a pleasing path to the Triple Aim.
Sadly, the trends of the government-medical-industrial complex are increasingly filled with the hubris that value can be forced from the top-down via controlling algorithms into which patients and their doctors become data points to be plugged in and controlled.
The degree of success we will see with any true healthcare reform will be the degree to which patients become more engaged and accountable. Those will need relationships with physicians deserving of their trust within healthcare delivery systems focused more on the value equation. Success simply has to come from the bottom-up, so this will force many true physicians to have to leave the more toxic delivery systems in some locales. They will be forced to either move or more directly interact with patients minus the misguided, controlling interference in their communities.
Dr. Oates is highlighting the comment I made in the post. Not all incentives are financial and we need to find a way for healthcare to more than just a financial reward.
As most of you know I do a fair amount of work with tech companies in my home town of Las Vegas. The most famous Las Vegas tech company (casinos aside) is Zappos. If you haven’t heard, Zappos has created a unique culture. Next time you’re in Las Vegas, let me know and we can go on a tour of Zappos together and you’ll see what I mean. Everything from allowing people in their office to decorate their desk (and they are unique I tell you) to the competitions and events they run. Their blog subhead says it all, “Experience fun with a Little Weirdness.”
Why do I bring this up? It turns out that beyond Zappos tech component, the majority of Zappos employees are call center employees. I heard one person describe Zappos as a big customer service call center. That’s not far off. If you’ve never worked in a call center before, it’s not what most would consider a “fun” job. However, the Zappos culture has created a place where people love working for a company that is paying them a low wage to answer the phone. Let me assure you that their employees are fiercely loyal.
I’m not suggesting that healthcare should adapt the model of fun and a little weirdness. What I am saying is that Zappos created a workplace where the job was about much more than just your paycheck. Healthcare needs to embrace a similar notion where doctors enjoy their job for much more than just the paycheck.