Synopsis

America’s healthcare system is the most expensive in the world, but more money hasn’t equated to better patient outcomes, explains surgeon-scientist Firouz Daneshgari. Consider this: Americans spend 300-500% more than those in Europe or Japan on healthcare, but our country consistently ranks between 30th-40th in the World Health Organization’s ratings for patient longevity, access to care and prevalence of chronic conditions. What’s worse, medical errors are the third leading cause of death in the U.S. Only heart disease and cancer claim more lives. Why are we spending so much, but getting so little?

In his new book, Health Guardianship: The Remedy to the Sick Care System, Dr. Daneshgari draws upon more than 30 years of research to offer an unflinching exploration into the systemic dysfunction caused (primarily) by America’s fee-for-service healthcare model. Procedures and surgeries generate revenue; healthy people don’t. Can our healthcare system be healed?

“We have built a system specialized for sick care, and yet ironically we expect the results of ‘healthcare’ from it,” he said.

Daneshgari details a framework for a new healthcare paradigm that prioritizes mitigation of health risks and elimination of chronic conditions, and rewards guardianship of health, not delivery of sick care services.

“My aim is to generate a national dialogue and movement toward a path forward that will create the next model of healthcare delivery. A model that will have all the medical and technological advances, and yet it is accessible, affordable, high quality and consumer-centric and not provider-centric,” Daneshgari said.

He describes how this new model can be implemented using the existing primary care infrastructure, with the integration of virtual health and wellness services to make proactive, consumer-centric healthcare as convenient and affordable as shopping and banking.

Acting like a whistle blower who calls out the existing dysfunction of the system, Daneshgari offers an imminently available remedy that would create the next generation of healthcare that is accessible to all, affordable by everyone and will provide the quality desired by healthcare consumers.

Amazon

Excerpt

I was appointed to the strategic committee of the board of directors of a healthcare system comprising 11 hospitals, 100 outpatient facilities, over 200 clinics, nearly 30,000 employees, and an annual revenue of nearly $3 billion. Blessed with this position of influence, I was excited to funnel my efforts toward making meaningful change in American healthcare at large.

However, I quickly realized that my understanding of the operations and dynamics within the American healthcare system differed greatly from that of the other board members. My fellow board members came largely from business and financial management backgrounds. And, while I focused on healthcare goals through improving patient care and physician training, the rest of the board prioritized the financial metrics of initiatives brought to our table. To understand why our priorities differed, I began to research the development of hospital boards and their governance structures. Taking a historical approach, I discovered how the American hospital structure evolved from charity houses in the late 19th century to the current oligopolistic, multibillion-dollar financial institutions present today.

I also discovered that the American healthcare system had become the most expensive system in the world, spending 300%–500% more than similar nations, but trailing those nations in patient outcomes. As a renowned professor and surgeon, I traveled the world and operated in many countries, and I witnessed the differences between our healthcare and that of other nations. I noticed that, despite its disproportionate price tag, the American healthcare system lacked a competitive edge in positive health outcomes. As a result, our country consistently ranked between 30th and 40th in the World Health Organization’s ratings for patient longevity, access to care, and prevalence of chronic conditions. I began to wonder about the causes of our healthcare system’s deficiencies. Why were we spending so much more, but getting so little in return?

Despite my years of experience in basic science and clinical research, I realized that I lacked the tools to even begin investigating these topics. I needed to acquire the fundamentals of business research and surround myself with an environment conducive to this line of questioning. So, I enrolled into the executive MBA program at the university where I was a clinical department chair. There, I shared ideas with some of the most brilliant and informed innovators in business. And, combining my newfound business knowledge with a lifelong clinical background, I began to see the problem more clearly.

In the world of business, everyone knew that our healthcare system was “sick.” They had done the research, and significant volumes of publications on “signs and symptoms” of this sickness were referenced daily in conversations. The prime example of this sickness is that “medical errors” have risen to the third most common cause of death in the United States, trailing only behind heart disease and cancer.

But with this new observation, my focus shifted away from describing these signs and symptoms toward a different line of questioning. How could our healthcare system be fixed? How could we make it more affordable for our nation, while improving patient outcomes such as better access to care, and a lower incidence of chronic conditions? Could we model a solution after existing approaches in other nations, while still meeting the demands of American society with its diverse geographical and cultural differences?

About the Author

Firouz Daneshgari, M.D., is a surgeon-scientist, educator and entrepreneur who has worked at the University of Colorado, Cleveland Clinic and Case Western Reserve University. He has published more than 200 scientific articles, led numerous scientific and clinical panels, and trained hundreds of students, residents, fellows and junior faculty.

Following implementation of the Affordable Care Act and approval of its mandates by the Supreme Court during 2010-2012, he founded BowTie Medical to create systematic innovations for bringing efficiency and value into the healthcare delivery system.

In addition to Health Guardianship, Daneshgari shares his views on healthcare and the path forward through his podcast, Why Can’t We Have it All? The Missing Pieces in Our Healthcare (www.wcwha.com).

For more information, visit www.bowtiemedical.com.