I'm Not a Doctor

A second opinion on the challenges and opportunities facing today's physicians.

Blog: Transformation may come amid fighting, sacrifice

9 am, Oct. 8

Noting that healthcare is in the beginning of its “Decade of Transformation,” healthcare strategist Marc Sauve told attendees at the 25th annual Healthcare Facilities Symposium and Expo in Chicago that “We are going to have to rethink everything.”

“There is going to be a lot of anger, fighting and people getting mad,” said Sauve, a consultant on healthcare provider growth strategies with Gresham Smith & Partners in Nashville. Then, quoting Dr. Seuss, he said the questions are complicated, but the answers are simple—and that these answers include shared sacrifice, compromise and negotiation.

Sauve, a perennial speaker at the symposium, noted how he successfully predicted last year that Congress wouldn't come to a meaningful agreement on deficit reduction. An easy prediction, Sauve acknowledged, but he said he also correctly predicted the Patient Protection and Affordable Care Act's personal insurance mandate would be upheld by the U.S. Supreme Court and Chief Justice John Roberts would cast the deciding vote.

“Maybe we were lucky,” he said.

For this year, Sauve predicted Congress would prevent sequestration-driven budget cuts called for in last year's Budget Control Act, but only do so by “kicking it down the road for six months.” He also predicted failure for legislative attempts to overturn the ACA.

“If you're waiting for repeal, good luck,” Sauve said, though he later praised GOP vice presidential nominee Rep. Paul Ryan for proposing Medicare reform. “At least he had has some guts to put the thing on the table.”

Each year, Sauve runs down the nation's top 15 causes of death and compares U.S. healthcare statistics with other countries. He noted how homicide fell off the list last year after a 10-year run, but countered by stating how the nation's suicide rate is “going through the roof” and how deaths from accidents are on their way up because of driving and texting. But all others are way behind the first and second causes—heart disease and cancer—despite “great strides” made in the treatment of both.

Sauve cited how the World Health Organization ranks the U.S. health system 37th out of 190 countries. While U.S. infant mortality figures are improving, he said the current rate of 6.8 deaths per 1,000 live births is “still embarrassing” and that statistics indicate the high rate is poverty related.

This link continues into adulthood as high school dropouts have a 2.5 times higher death rate than students who go onto college, he said, adding that our “28% high school dropout rate is killing us.” Education is the key to getting people out of poverty and toward a healthier lifestyle, he said.

As health systems transform, Sauve said “there needs to be a physician at the head of the table,” and he criticized how hospital CEOs are all talking about how they need “physician alignment.”

“You need physician partners—just because they're employees now doesn't mean they are cooperating,” he said, adding that nurses need to be empowered as well.

Follow Andis Robeznieks on Twitter: @MHARobeznieks.

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