Cheap vs. Efficient
Reducing cost improves efficiency only if you keep the healthcare provided a constant. Otherwise, you're just providing cheap healthcare. Sometimes that's OK, as long as the basic quality is there, and the customer knows what they're getting. Customer satisfaction means closing the gap between expectation and reality. I recall an HMO in WI that purchased cheap readings on PAP smears. The pathologist just stamped all reports "normal" without ever looking at the slides. The results were not good, but they were cheap. On the other hand, my wife stays at Motel 6--except when she's travelling with me. Motel 6 provides a high quality service at a low price, but I want a little more. And I'm willing to pay for it. But this is about luxury, and has nothing to do with either quality or efficiency.
How do you improve efficiency but maintain quality? Start by mapping the process and eliminating non value-added steps. Improve productivity: I can reserve a plane ticket or a hotel room on the Internet. This saves the company money and makes the reservation task easier for me. Lower cost and higher quality. Now, why can't I make an appointment with my doctor the same way? Technology has been slow to come to healthcare. A solo family practitioner would become more efficient if he hired a receptionist. His productivity would increase, because he's no longer required to answer the phone and open the mail. Productivity would probably jump again if he joined a group. Again, improved efficiency due to lower cost per unit service. Same doc, same patients, same service, but lower cost. And the group might have a computer!
What about hiring less qualified providers? An OR tech rather than an OR nurse. A nurse practitioner rather than a physician. The list is endless. Most are less expensive, but the service is different. That makes it a different equation (different denominator) and not always more efficient. A related issue is the nurse who's been here for 30 years with a 10% raise every year. Administration wants to replace her with a (cheaper) new graduate. This is faulty personnel policy and again changes the equation. Experience is valuable--especially as a member of a high performance team--but only up to a point. Set that point early.
Some seek healthcare overseas as a less expensive alternative--pills from the Provences are one thing, but I'm talking about open heart surgery in Bangkok! Is this more efficient? Only if the service is the same. Is this the Motel 6 of healthcare? Only if you know what you're getting. US hospitals are capable of providing the best healthcare in the world. They don't always do this, but the odds are favorable.
