Improving Health Care By Removing Ego

I hate traditional networking. I hate it so much I don’t even want to blog about it. I am going into this article kicking, screaming, and procrastinating…let’s start on a positive note:

I love Dr. Erik Steele’s columns in the BDN. He’s a breath of fresh air in that he surgically applies common sense to health care issues. In a recent column he shares that he first made a decision about whether or not to have a procedure done before undergoing an MRI. He reasons that there’s no point having a very expensive test performed if he isn’t going to make use of the findings. Brilliant use of horse sense, that.

For as much as I admire Dr. Steele, I have never met the man and that’s part of why healthcare sucks.
Not only do health care providers fail to network in ways that would improve patient care, we don’t even play nice with each other. We tend to compete and not collaborate because most of us work from the false belief that there are not enough patients to go around. (There’s too many in truth).

Everybody wants to be the Wal Mart of health care (including um, Wal Mart). For decades now state and federal laws have been systematically pricing small health care providers out of the market through changes in public policy. This trend has been fueled by the practice of giant corporations buying out small providers without renaming them. Double check with your local provider – there’s an excellent chance that what you think is an old family business is now a tiny piece of a corporation that sees tens or hundreds of millions a year in gross revenue.

What’s the solution? Depends on your politics and I am sick to death of politics. I am concerned with the next patient in front of me, not with whether or not Obama Care is the worst thing ever or whether monopolies in Maine’s health care exist (of course they do). I’m a pragmatic idealist – I like ideas and I like change, but I’m more concerned with doing the best I can do today with what I have. I think that’s a big part of what being a Mainer is all about.

Sure, sure, managed care is evil and blah, blah, blah. I get it. I know! I also know it’s here to stay. So…given the parameters of what is likely to change real soon and what is not, here’s what I’m thinking:
Let’s work together. No, really. Let’s do that. Let’s all check our mission statements and remember why we got into this field in the first place. Now let’s raise the bar by making meaningful connections.

I have no interest in doing things I don’t do especially well so I don’t do them. I would much rather lose money than provide a mediocre service. So here’s the thing – we need each other. I am prepared to do most anything to make the needed connections happen – anything at all – just not…please God, NOT traditional networking.

I don’t want to go to stupid meetings in your stuffy conference room. I don’t want to eat dried out chicken at your annual functions. I don’t want to tour your new state of the art multi-million dollar facility. I don’t want to put on my sports coat or worry about wearing a tie. I don’t want your business card and I don’t want the name of the guy who increases your web presence.

I’d rather be a real person. I’d rather meet you on a Saturday wearing cut off jeans and a tee shirt. I’d rather hear about your heart’s longing than your annual budget. I’d rather eat sushi or cheeseburgers with you and talk about why you love your job. Then give me your number. If you’re really damned good at what you do then let me know – I’d be thrilled to give people your number. I am prepared to cover my office walls in blackboard paint and write your name in big chalky letters.

If you insist on making professional resource lists then okay…we can do that. You know where I get my best resources? Single moms. They can tell you who has the best bedside manner, who is the most highly skilled, who has a wait list longer than your arm AND they can tell you who has the best price on pork chops this week. That’s networking. It’s simple, it’s effective, and it works. If you gave me a choice between a professional award and being made an honorary single mother, guess which one I’d pick?

Here’s the other thing: the hip bone’s connected to the leg bone. What you do is connected to what I do. I work in addictions and trauma recovery. Those things are intimately connected to diabetes, G.I. problems, and a million other conditions. On the flip side, you’ve referred your patient with obesity to a nutritionist for the third time in two years but haven’t asked about a history of abuse or how much they drink. Let’s connect the dots together.

Every managed care form I fill out asks me if I have coordinated care with the patient’s Primary Care Physician (PCP). I would love to work in a field in which doctors return my phone calls and emails. I would love to work in a field in which folks with fewer letters after their name than I aren’t shocked when I call them. Let’s destroy the hierarchy. I don’t give a damn how much education you do or do not have and I’d really love it if you didn’t call me Mr. LaPierre and I didn’t call you Dr. Soandso. How about you be Tim or Betty and I’ll be Jim. Radical notion: being real people makes us better healers.

Finally, I don’t have competitors. There are plenty of folks who do what I do and I recommend the ones I I know who do it well. I am a lousy businessman. You’ll find business cards and information about outside practitioners in my office and on my agency’s web site. My simple truth is that health care organizations tend to behave like dysfunctional families within their practices and like gladiators towards outside organizations. We have the ability to improve patient care by talking to each other like real people and cooperating. It’s that simple.

Jim LaPierre

About Jim LaPierre

Jim LaPierre LCSW CCS is the Executive Director of Higher Ground Services in Brewer, Maine. He is a Recovery Ally, mental health therapist and addictions counselor. He specializes in facilitating recovery (whether from addiction, trauma, depression, anxiety, or past abuse) overcome obstacles, and improve their quality of life. Jim offers a limited amount of online therapy to those with very flexible schedules.