Joe Ketcherside, MD The Ultimate Goal of Healthcare

Fiscal and Physical Asset Management has much to do with context.  That is, what circumstances brought you to acquire a particular asset? A recent post from Joe Ketcherside, MD, Co-founder, President, CEO of Cognovant Inc caused me the hit the rewind button.  I thought about the greater context in which we operate.  Getting Dr. Ketcherside’s perspective is important to me because of the path reflected in his résumé:

- Product Manager for a software company

- Chief Medical Officer

- Chief Medical Information Officer

- CEO of 2 informatics and consulting companies

I asked him, “What do you think should be the ultimate goal of healthcare whether it be government, IDN, Medical Center, or Hospital?”  For me, these types of ideals should drive the asset management program.

Dr. Ketcherside’s reply:

My thoughts on the ultimate goal of healthcare are shaped by three phases of my life.  As a surgeon, I was in a combined academic/private practice and cared for many patients.  In my journey through healthcare IT, I have worked both as a designer and manager for vendors and in senior leadership positions in several health systems.  I have seen things from the other side of the exam table - as a patient and helping family members through complex health issues.

I actually don't make a distinction between government health care, IDNs, or private physicians. In all of those organizations, our focus is the same – the patient.

Speaking first from my position as a physician, there are some principles I used in care.

-      Understand why the patient is here and what is wrong. That was partly to make the diagnosis of the immediate physiological issue that brought them, but additionally to include understanding how this medical issue fit with their job, their family, their beliefs.  Cutting something out and sewing them back up without addressing these other issues didn't necessarily mean they went back to life and work successfully.

-      Be a good steward of limited resources. By that, I mean to be cost-effective in care, consider the financial impact to the patient as well as the clinical.

-      Consider the patient's beliefs and desires in my recommendations for care. Most medical answers aren't black and white, so helping the patient consider alternatives is key. Many of the issues I treated as a neurosurgeon had their origins in lifestyle choices. I know it sounds strange from a neurosurgeon, but choosing to be sedentary, choosing to smoke, to drink and drive, to not wear a seatbelt or helmet, and so on were the origins of many of the ills I treated.  Engaging my patients in managing their health was crucial.

My goals as part of a healthcare system were similar.  But, the economic factors must be considered even more. The organization must remain financially viable, even if it is a non-profit.  My favorite CFO pointed out “no margin, no mission” in reminding us that if we managed irresponsibly there would be no health system to care for those in need.

My experience as a patient probably has the greatest impact, even with my knowledge as a physician. Several key areas draw my concern:

-      What’s really wrong and what will it do to me?  Am I going to die sooner than I thought?  Am I going to wish I was dead?  Will treating this be worse than the disease?

-      How will I pay for this?  What is going to change in my life and my career?  Who is going to take care of me/Mom/other relatives?

-      Where do I find answers?  How do I learn more about this disease and its treatment?  How do I ask the right questions?  How can I feel like I have a little control over my world?

-      How to get involved?  How can I keep track of the important labs and medications?  How can I communicate with the doctors?  How do I make sure this all works right?

If you ever want to feel helpless just try being a patient or care for a seriously ill family member.

These all tie together in my ultimate goals for healthcare, and guide my work as I develop tools and systems to improve health outcomes:

- To find the best way to resolve the acute issue that presents in a way that fits with my patient's needs, beliefs and goals.

- To help my patients understand how they can influence and manage their own health  live their lives to the fullest.

Achieving these require us to strive to help people have the knowledge, tools and resources to maintain their wellness, and to recover from illness to the best of their abilities.