We have all heard the best offense is a good defense.  Well in the case of the health of American citizens this just isn’t the case.  To be honest this was a little bit of a new one to me, although common sense would tell you it is all too common.  On Jackson Healthcare website this past week the following article was posted.

Physicians attribute 26 percent of overall healthcare costs to the practice of defensive medicine according to a study released today by Gallup and Jackson Healthcare.

Physicians generally estimate that defensive medicine costs are higher overall when compared to their own personal practice. While physicians attribute an average of 26 percent of overall costs to defensive medicine, 13 percent believe the practice constitutes 50 percent or more of the cost.

Of the physicians surveyed, 73 percent agreed that they had practiced some form of defensive medicine in the past 12 months. Twenty-three percent of practicing physicians estimate that defensive medicine constitutes less than 10 percent of their practice while 29 percent estimate the percentage to be between 10 percent and less than 25 percent.

Physicians indicating they had practiced a form of defensive medicine in the last twelve months attribute 21 percent of their practice to be defensive in nature.

In the study, defensive medicine was defined in this manner:  “Defensive medicine is the practice of diagnostic or therapeutic measures conducted primarily not to ensure the health of the patient, but as a safeguard against possible malpractice liability. This may include tests, prescriptions, hospitalizations and referrals that may not be medically necessary, but are viewed as providing protection from a potential lawsuit.”

Jackson Healthcare retained Gallup for the study in an effort to quantify the scope and impact of defensive medicine practices in the U.S.

Results are based on telephone interviews with 462 randomly selected US physicians. Interviews were conducted in December and January.

—Credit Jackson Healthcare & Gallup

So all that said; as stated in the past on this blog, there are some real healthcare reform needed in this county and I am not sure we are focusing reform on where it needs to be.   Best offense is a good defense?  In this case, playing defense isn’t even in the best interest of Americans’ health.

—Marty Hudson

At the one year anniversary of the economic stimulus plan President Obama declares the economic stimulus plan an unequivocal success that has created or saved millions of jobs.

On the other hand, critics are pointing out a continuing dismal jobs picture and deflating public confidence as signs that the stimulus bill, as one GOP leader put it, was “fiction” and not worth the cost.

Recent comments from the President Obama include:  “We have rescued this economy from the worst of this crisis…”  The measure “was never intended to save every job.  Businesses are the true engine of growth [and] always will be. But during a recession … what government can do is provide a temporary boost.” The program “runs cleanly, smoothly and transparently.”  “We acted because failure to do so would have led to catastrophe. One year later, it is largely thanks to the recovery act that a second depression is no longer a possibility.”

Vice President Biden stated, “Without any question” the package is working and “laying the foundation” for long-term economic growth.

Senate Minority Leader Mitch McConnell, R-Ky., said, “In the first year of the trillion-dollar stimulus, Americans have lost millions of jobs, the unemployment rate continues to hover near 10 percent, the deficit continues to soar and we’re inundated with stories of waste, fraud and abuse.  This was not the plan Americans asked for or the results they were promised.”

There is the rhetoric.  Here are some facts. 

The United States of America owes $1.6 trillion more today than it did a year ago.  The national debt has reached nearly $12.4 trillion, while this fiscal year’s deficit is expected to hit about $1.6 trillion.

In the last year the jobless rate has climbed from 8.1 percent to 9.7 percent.  While employers may be shedding fewer jobs than last year, 49 states saw a net job loss in 2009.  A recent CBS News/New York Times survey showed only 6 percent of Americans believe the stimulus has created a significant number of jobs.

The bulk of the money initially allocated for the plan has not actually been spent yet. Through the end of January, roughly $334 billion in spending has been approved, of which only $179 billion has actually been released.  Another $119 billion has gone to tax cuts.  Now that the economy is no longer in free fall, the mix of spending will change, senior administration officials said. Until this point, the bulk of the spending has been on tax relief and direct aid, such as unemployment benefits.  To date, only $31 billion has been spent on projects such as infrastructure, high-speed rail, broadband and health technology.  

So, if the bulk of the Economic Stimulus hasn’t even been spent, how can they tout that it’s working? 

You tell me – The Economic Stimulus Plan – What Changes Have You Seen?

—Marty Hudson

A few years ago we read a book by Fred Lee, “If Disney Ran Your Hospital: 9 1/2 Things You Would Do Differently.”  In reading the book we quickly realized our conviction in deploying M3-Patient Experience matched up with what Fred said in his book.  We contacted Fred, met him at the airport in Orlando for lunch and asked him to take a look at M3-Patient Experience.  After spending a considerable amount of time, this was his unsolicited comment:

“I liked all the questions in your survey and could honestly not think of anything I felt was not covered. It is really an electronic work of art. You are to be highly commended. I can recommend it highly, and you can quote me on that!”

With that I would like to share with you some of the points Fred makes in his book, as well in presentations he makes to healthcare operations around the country.

Focus on What Can’t be Measured.  When we focus on the perceptions of the patient the efficiencies will follow.  In other words, when we treat the patient with compassion, we will meet the patients’ needs efficiently and effectively.  Every patient is different, compassion helps you focus on the need of every patient. 

Make Courtesy More Important than Efficiency.  By first being courteous to the patient, which creates an external focus (focusing on the patient’s need), bringing responsiveness to the patient’s need, which promotes sharing of resources, and ultimately results in overall organizational efficiency and teamwork; creating a memorable experience for the patient.

Measure to Improve, Not to Impress.  When we measure the patient’s experience with the focus on improvement, understanding each patient is different, we continuously find ways to get better.  If we are merely measuring to impress we are more focused on average scores and if we are at least better than someone else, when “someone else” might be pretty bad.  Continually improve and your patients will not only be impressed, but will be loyal.

Closing the Gap between Knowing and Doing.  “Like losing weight, our problem is not with knowing how. When we want to enough, we figure out how and learn by doing.  Our problem is with being committed enough to do what it takes every day, and do it permanently, not just in short bursts of inspired energy.” — Fred Lee

Here is a link to a slide show from some of Fred’s speaking engagements I found posted on the web:  http://tinyurl.com/fredleeifdisney.  I encourage you to read his book.  But most importantly when providing care to your patients I challenge you to improve continuously and ask yourself, “What Will I Do Differently?”

—Marty Hudson

We started looking at some of these statistics when Google announced they will discontinue support of IE 6 on March 1.  To continue to use some of Google’s services, users will have to upgrade to at least IE7.  Recent cyber attacks, via a flaw in IE6, against Google and other companies have created this move from IE6, but there remain a high number of users continuing to use IE6.  Personally, I believe whatever browser you use, you should upgrade to the most recent version. 

Google set the baseline for other browsers; with Firefox 3.0 or higher, Chrome 4.0 or higher, and Safari 3.0 or higher. “…you may find that from March 1, key functionality within these products–as well as new Docs and Sites features–won’t work properly in older browsers,” Google said.  Google continues to drive a lot of how the internet is accessed and utilized.  This kind of gives me a flashback to my blog back on December 15^th, “When Will Google Take Over the World”. 

Stats for January 2010, from Net Applications, shows IE users make up 62.2% of internet browsers.  This is down from 62.7% in December 2009.  Firefox users are also down slightly from 24.6% to 24.4%.  Chrome continues to grow and is at 5.2% in January, and Safari is staying level at 4.5%.  IE 8 (22.3%) actually passed IE6 (22.1%) users during the month of January.  IE 7 users follow at 14.6%.   

This prompted me to take a look at what browsers MedicalGPS users access our website and tools.  Comparing January 2010 to January 2009, here’s what I found.

                                                  2010               2009

Internet Explorer                      68.09%            82.39%

Firefox                                     21.88%            11.90%

Safari                                         6.89%             4.57%

Chrome                                     2.38%             0.31%

Other                                         0.76%             0.83%

A further analysis of just IE users shows how the versions of IE have changed from January 2009 to January 2010.

                                                  2010               2009

IE7                                          46.19%           68.53%

IE8                                          27.63%             0.75%

IE6                                          25.85%           30.68%

Older IE                                    0.33%             0.04%

Internet Explorer will continue to lead the pack for the foreseeable future, but as other browsers become more sophisticated, secure and competitive we will see Internet Explorer Still No. 1…But Fading.

—Marty Hudson