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Thoughts, comments, news, and reflections about healthcare IT from Microsoft's worldwide health senior director Bill Crounse, MD, on how information technology can improve healthcare delivery and services around the world.

There’s no business like the healthcare business, like no business I know

There’s no business like the healthcare business, like no business I know

  • Comments 3

clip_image001Irving Berlin eat your heart out. There’s no business like the healthcare business or so it seems from a recently published info-graphic in the Wall Street Journal. Where are the jobs in America? You guessed it, healthcare. But is that a healthy thing for the economy, or a leading indicator of an insidious illness?

First of all, let me apologize to every clinician reading this. As a doctor myself, I know there is nothing more distasteful to a physician, nurse, or anyone else who works in healthcare than referring to the industry as a “business”. To clinicians healthcare is a profession, a calling, a mission, but please not a business. However, whatever you want to call this two trillion dollar enterprise, it does represent a really significant piece of the US economy. In fact, in almost any developed country in the world it takes a pretty big bite.

No matter how you feel about healthcare, looking at the employment changes in the US over the last decade or so, one has to wonder if this could be considered a healthy trend in any country? And, is it sustainable? Furthermore, what does it really produce? I know that’s a very complicated question on many different levels. It does produce health and therefore when it works, it restores and prolongs human life and productivity. That is certainly a good thing for an economy. However, we also know it is a system that wastes a lot of money. In the US, by some estimates, it wastes as much as a third of all we spend.

So, looking at the map, is this a good thing for a country or as I said, an insidious cancer that is eating away at everything else we need to fund? Having spent some time with government leaders and health ministers around the world, I can tell you nearly everywhere, officials are increasingly alarmed about how much of their nation’s treasury is going to healthcare instead of the other necessities required for a robust and sustainable economy. Clearly, this calls for another approach. Healthcare shouldn’t be the leading employer in America, or for that matter, in any other country.

How do we use technology to redistribute knowledge and care in such a way that we gain far more productivity in the healthcare workforce while enabling patients and citizens to do more for themselves? How do we deliver only the most appropriate and effective care exactly when and where it is needed? How could we use technology to redistribute health and healthcare capacity around the world? What kind of partnerships and innovations are needed to reduce the cost of healthcare? How do we make smarter decisions about care and cure? These are some of the questions that must be addressed, and soon. If not, America might become the first economy in the world brought down by the very industry that is supposed to keep all of us well.

Bill Crounse MD      Senior Director, Worldwide Health          Microsoft

  • I'd be curious to see where the breakdown in new jobs are added in healthcare. Are we adding more caregivers? Are we adding layers of management?

    And I share your fears. It's all trending towards a nightmare in which "the solution" will be to continually throw money at it (like the VA) without any thought towards better delivery of patient care, etc.

  • The healthcare industry continues to expand and some might call it "recession proof." A lot of this growth is seen on the lower echelon of the industry. I'm not saying it's bad but 50% of the healthcare industry lacks a bachelors degree. With the physician shortage, there needs to be more of a discussion on the ways we can fix this problem. The shortage was a major part of the problem at the VA and it's a major problem at money other healthcare organizations. Below is an article that is very interesting and the site is a great resource for physicians and physician groups.

    www.medicalgroups.com/brookings-institute-50-healthcare-industry-lacks-bachelors-degree

  • I think you are right on the money about better use of technology as there's no shortage of technology out there, but how much redundancy is there and how much data and as you said on Twitter as well is revelant directly to care.  I'm also a privacy advocate and I keep seeing more reaching for the stars if you will with predictive analytics and the data bought and sold for this purpose.

    Sure, we can gain a lot of foresight from data from clinical charts, identifying patterns and so on and that's a good thing, but when they start pulling in consumer credit card data as well as some other obscure information, is all of this really needed as it costs money to process, hire people to work with such and so on.  

    On top of that when consumers find out how much of this type of information is on file about them with no permission given or the consumer even asked, well, it's going to have an opposite effect in the long run as we won't like it.  It takes away from the human to human relationship that healthcare is all about.  

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