Transformative Restoration

As we prepare to leave 2010 and move into 2011 it is only natural to look back while looking forward. We can truly say that 2010 was the year of "transformation".

We saw the passage of the health care reform bill, the HITECH bill, the transformation of how the American people view almost everything in their lives due to the great recession and the explosion of TransforMED as the gold standard of practice and health care transformation. While 2010 was the year of transformation, will 2011 be the year of "restoration"? America's values will hopefully be restored to what is truly important— family, an acceptable standard of living for all, health and well-being.

We talk about the health care system in this country needing "transformation". Indeed TransforMED's name is built on that. What the health care system may really need is "restoration". We need to restore the US health care system to the basic values that will actually make a difference in the lives of patients. Those values are the concepts of the Patient-Centered Medical Home— A continuous relationship with a personal physician over time for wellness and illness.

Is working as a team, managing and coordinating care, using technology at hand or seeing patients when they need to be seen really transforming? One could argue that it is restoring the values on which primary care was founded and were valued until payment methodologies deemed otherwise.

The current payment system for health care in the United States performs perfectly for what it is designed to do---reward volume and procedures. The visionaries that created the current payment methodology determined that more health care would lead to better health care and thus better health. We now know that not to be the case. It is time to restore the value of a health care system based on personal relationships, meaningful activities focused on outcomes (and not volume) and the patients being active participants in their health and well being.

We need to restore the environment where the physician can make a judgment in the best interest of the patient and not what will prevent a lawsuit or generate more volume. We need to restore the environment where the patient no longer values more health care over better health care. We need to restore the environment where broad-based primary care training and personal relationships are valued as the key to health and well-being and not super-specialists and cutting edge technology for everyday problems.

The way to successful restoration will ultimately be transformation. The current US health care system is badly broken. Too much is done to too few for the wrong reasons. Just simply hoping for a reset to more rational times is not realistic. We must therefore embrace meaningful, substantive transformation.

The concepts of the Patient-Centered Medical Home are really not new, but we have gotten so far away from what is truly important and what will truly make a difference in patients' lives that nothing short of transformation around those principles will get us to where we need to be.

The goal of transformation is indeed restoration framed in the realities of today. We are not trying to restore our grandparents' health care, but we are trying to restore the values of that era with the technology and challenges of today. The long term relationship with a personal physician should be timeless, as should the goal of health and wellness.

The challenges of today may actually be opportunities if the right things for the patient can be valued, technology can be harnessed, patients can be engaged and the country's leadership has a clear vision. The opportunity then becomes one of "transformative restoration".