Many have noted that the Holy Grail of getting a handle on sick-care spending is changing both patient and doctor behavior. Perhaps it is time for a more personalized physician approach.
Most everyone agrees that there are significant sick-care outcome disparities in the US. Patients assume that their doctors treat everyone the same.
Instead, research suggests that implicit bias may contribute to healthcare disparities by shaping physician behavior and producing differences in medical treatment along the lines of race, ethnicity, gender, or other characteristics.
This is but one of many reasons why a doctor in one location (or even the same office) treats patients with the same problem in another location differently for a higher cost. Getting doctors to adhere to evidence-based guidelines is a messy business. The adherence rate now is about 50%.
Many have noted that the Holy Grail of getting a handle on sick-care spending is changing both patient and doctor behavior.
Perhaps it is time for a more personalized physician approach, similar to what online retailers do with all of us and digital health entrepreneurs are doing with patients.
1. Using data to inventory and categorize individual physician prescribing habits and interventions.
2. Using the data to define outcomes.
3. Calculating the cost of a given episode of care for a given doctor and comparing that to others.
4. Nudging change managing the delta.
5. Alerts to avoid bias triggers.
6. Giving doctors more diagnostic and treatment wiggle room.
7. Pay for performance based on rate of improvement, not absolute outcomes.
8. Use the information as a teaching tool as part of intervention simulations.
9. Monitoring variations in patterns to detect and understand why a doctor changed.
10. Having a virtual personal physician assistant to provide alerts and gentle whispers in the doctors ears to prevent them from going in the wrong direction.
Having a personal clinical eminence grise or consigliere might help change doctor behavior just as Amazon has been able to change your reading habits. Jeff Bezos seems to have found the Holy Grail. Why can't we?