Theres a scene in Animal House when Otters solution to a confrontation with Dean Wormer is to throw a toga party. Hoover, Delta House president, at first rejects the idea. Otter and Bluto then whip their fellow fraternity brothers into a party-throwing frenzy by chanting, toga, toga, toga. By the end of the scene, Hoover is jumping up and down, reluctantly chanting toga, toga, toga along with the other Deltas.
Healthcares sacred cows
Have Berwick and Gingrich become too powerful for the common good?
The healthcare industry has its own Otter and Bluto right now. Theyre Donald Berwick and Newt Gingrich. Berwick is president and chief executive officer of the Institute for Healthcare Improvement. Gingrich is the founder of the Center for Health Transformation. Berwick is the charismatic leader of the patient-safety movement. Gingrich is the charismatic leader of the price transparency and information technology movements. They may not belong to the same fraternity, but Berwick and Gingrich certainly know how to whip their followers into a frenzy and, like the reluctant conversion of Hoover, can pressure even the biggest skeptics into going along with the cause.
Now, granted, improving patient safety and disclosing prices for patient care are much more noble causes than throwing a toga party (at least it seems so now that Im 46 and not 18). But the dynamic is much the same, and that gives me pause (now that I am 46). At the moment, who dares question Berwick or his actions; who dares question Gingrich or his actions? Anyone who questions either demigods motives will be stoned as a heretic. They are that powerful, and thats not necessarily good, although their causes may be. Their omnipotence may overshadow other strategies or alternatives that could help patients both clinically and financially. Like any industry, diversity of opinion drives healthcare forward.
All this came to mind last month when I read reporter Andis Robeznieks coverage of the IHIs annual meeting in Orlando, Fla., (Dec. 18/25, 2006, p. 8). At that meeting, Berwick announced his 5 Million Lives Campaign, designed to prevent that many incidents of patient harm from poor hospital practices through Dec. 9, 2008. That tops his 100,000 Lives Campaign, which saved, thanks to some creative accounting, more than 122,000 patients from certain death over an 18-month period ended last June. When the IHI announced its initial 100,000 Lives Campaign, many major healthcare organizations endorsed the cause. That is, with the notable exception of the American Hospital Association.
At that time, the AHA tipped its hat to Berwick but said there were other efforts to improve patient-safety and to endorse one program would disrespect those efforts
(Dec. 20/27, 2004, p. 14). Still, by the end of that program, some 3,103 hospitals signed on to the cause. Fast-forward two years, and whos kissing Berwicks latest project? The American Hospital Association, thats who. (Or should I say Hoover?) According to the IHI, the AHA will serve as a national champion and clinical adviser to the 5 Million Lives Campaign, which hopes to draw 4,000 hospitals as participants.
Was the AHA right then and wrong now? Or is it the other way around? My guess is, at this point, not joining Berwick in his quest is tantamount to being against patient safety. If the AHA and hospitals dont follow Berwicks lead, hospitals could suffer a public relations backlash regardless of what individual organizations are doing outside of the IHIs campaign to make patient care safer.
As for Bluto, aka, Gingrich, hes facing another full calendar year of keynote speeches at healthcare conferences, pushing his dual agenda of price transparency and IT adoption. As reported in this magazine and elsewhere, Gingrich accepts paid consulting engagements on those topics, and his for-profit organization accepts money from outside organizations with vested interests in those topics. Still, hes fawned over after every presentation he gives at a healthcare event. Does your toga still fit?
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