I'll introduce Professor Clayton Christensen and then I'll get out of the way...
Dr. Christensen wrote a book called The Innovators' Prescription and he wants to solve the healthcare crisis by "disrupting" it.
Dr. Christensen proposes paying doctors based on one of three "tracks" that exist in medicine:
- Track One is like Gregory House, MD. Dr. House tries to separate the "zebras" from the "horses" - there is a high need for intuitive diagnoses. The process described brings to mind episodes of House, a TV show in which a brilliant but irascible doctor challenges a team of colleagues to find the problem before the patient dies.
Fee for service would continue to apply to these diagnostic services.
- Track Two is Fee for Results which would apply for treating conditions that are well understood and have a clearly defined solution -- total knee replacements, colonoscopies, laser eye surgery, implantation of stents, etc.
These are production problems that will yield to mass production techniques used in other industries. Whether we need expensive orthopedic surgeons at $500,000 per year performing assembly line processes is an open question.
Obviously, cost savings are available in Track Two.
- Track Three is user networks for patients with chronic conditions or unhealthy practices to learn how they can help themselves and be motivated to do so.
Physical therapists addicted to the volume model of providing "more" services will suffer like steel companies and auto companies in Dr. Christensen's video and book.
Let me know what you think.