Mature Market Experts Gem of The Day: Onions on pizza or blood pressure control?

CB101032 Center for Medicine in the Public Interest

Mature Market Experts: more mature market news and stats more often: Electronic Medical Records –

 

“Hello, Supreme Pizza, Carmen speaking, how can I help you Dr. Applebaum?” 

 

How do you know my name?

 

“Caller ID my friend, would you like the usual, vegetarian with extra onions delivered to 23 High Side Lane?”

 

That would be great.  “Ok Dr. it will be there in 20 minutes and we’ll charge it to your credit card on file ok?”   Sure, thank you, goodbye.

 

Every day we interact with sales or service organizations that have an enormous amount of information about us in their computers. They use this information to provide accurate, efficient and timely service. We’ve come to expect this and get frustrated when we deal with companies who are “still in the stone age” – sound like your doctor, perhaps?

 

Most physicians have computer systems to manage the billing for their practices, but less than 10 percent of America’s primary care physicians use computers to manage their patients’ medical information.  

 

Several studies have measured the percent of patients who get appropriate care for common medical problems. Results vary, but are mostly in the 50-70 percent range (i.e. blood pressure control).  Imagine if you got the right pizza on 60% of your orders, or FedEx delivered 30 percent of their packages to the wrong home, or if your bank’s ATM only gave you cash 50 percent of the time. 

 

Obviously, these companies would be out of business in short order. All of these industries are motivated to satisfy their customers.

 

Our health care industry, in contrast, is paid to take care of sick people, not keep people healthy. For the most part, the “medical industrial complex” is more profitable when more people are sick, not healthy. Hence in America, we have Sick Care, not Health Care.

 

We would all appreciate not having to go over our entire medical history every time we meet another provider. We would also feel a lot safer if we knew that any emergency department could retrieve information about the medications we take, the allergies we have, and the tests we’ve recently endured. This would save huge sums of money and minimize redundant, uncomfortable and potentially dangerous procedures.

 

So how can we get American medicine on par with the trucking industry and pizza parlors?  If we wait for major health care system reform we will continue to cut down thousands of trees creating millions of incomplete, inaccurate, eligible un-searchable medical records.

 

Rather, we should trust that a national system of comprehensive medical records will lead to improved outcomes and decreased costs.  While the political landscape for health care system reform is a mine field, who can argue against improved information at your doctors fingertips?

 

Clearly the country that put a man on the moon in 8 years and won a World War in 5 is capable of building a data-base to manage all of its citizen’s medical information in a safe, secure, privacy insured system. 

 

The federal government could stage several competitive design and management competitions and develop a plan in less than two years.  It could be implemented in less than another two. 

 

The only thing needed to digitize and thereby revolutionize American health care is leadership.  So next time your Congressman asks your opinion on health care reform or a politician asks you for a contribution, ask them if they will help you control your blood pressure, or just promise you onions on you pizza.

 

Gary Applebaum, M.D., is a senior fellow at the Center for Medicine in the Public Interest and a team member of TR Mann Consulting. He is the former Executive Vice President and Chief Medical Officer of Erickson Retirement Communities.

Mature Market Experts Stat of The Day: Multiple Chronic Diseases On The Rise

42-16033240 mature market overweight

Mature Market experts: more mature market news and stats more often: Multiple Chronic Diseases On The Rise- “The percentage of mature market Americans with three or more chronic illnesses rose even more sharply.

It jumped from 13 percent in 1996 to 22 percent in 2005 for ages 45 to 64, to 45 percent for ages 65 to 79, and rose from 38 percent to 54 percent for those 80 and older. Among all ages, it went from 7 percent in 1996 to 13 percent in 2005.”

Source: MSNBC

Note: Why do I believe that chronic diseases are on the rise? Because our lifestyles are becoming more unhealthly EVERY day and because we practice reactive medicine rather than preventive. Or as my TR Mann Consulting teammate Dr. Gary Applebaum says, “in the U.S. we practice sick care.”

Sick Care, You Get What You Pay For (Part 2)

Healing the American Health Care System

Fellow Mature Market Experts, last week we agreed that we have a sick care system that rewards those who treat us rather than heal us or keep us healthy. So how do we convert a sick care system to a health care system?

Let’s go back to the beginning, “you get what you pay for”. We must devise a system where those who have superior outcomes and truly keep us healthy are rewarded, not those who simply provide care. Naturally this assumes we can measure outcomes and that’s where we have to start.

First and foremost America must put into place a comprehensive, secure, central database that would enable all of our medical information to be stored, organized and searched. Ultimately this would allow us to determine which providers are truly enhancing health and not just treating sickness.

Once we have quality information (see Tom’s previous post on this subject and Google) it could be made public and used by patients to seek superior care. This information would also be used by insurers to determine appropriate reimbursement. Clearly people who keep you healthier should get paid more! I’ve always said that it takes you five minutes to decide if you like your doctor and at least five years to know if he’s any good.

Last week I admitted a patient into a hospital whom I had never met. After taking her medical history and examining her I was pretty certain I knew the correct diagnosis. I felt she had a viral GI syndrome, but something did not sound right. Her recollection of certain key historical facts did not add up.

Since there was no easy way to check her medical history on the internet I spent 45 minutes tracking down her paper chart at another hospital. I found that she had been admitted there with a similar story but ultimately was found to have a flare of Crohn’s disease which was successfully treated with IV steroids. This dramatically changed my treatment plan and saved the patient some unneeded tests and treatments.

Naturally I was thrilled but I received the same payment from Medicare that I would have if I had not spent the extra time and effort. Physicians want to do the right thing and go the extra mile but as with all other professionals they need to be rewarded when they do so. Doctors are human too!

And as consumers we must also take responsibility to have a lifestyle that leads to health and not sickness. Despite the significant number of Americans without health insurance, the majority of us does have insurance and pay a very small part of the premiums. Most of the costs are paid by employers or the government in the case of Medicare and Medicaid. Generally speaking, people don’t value what they don’t pay for; and you have to wonder if people would take better care of themselves if their insurance rates reflected these efforts.

My grandmother always used to say “if you have your health, you have everything.” Well, we need to honestly look at our system of care and decide if we want to have our health or have the growing beast of our current sick care system. Fortunately it’s not about money, we’re spending plenty. It’s about the commitment to focus on long term outcomes rather than short term revenues.

Ultimately those of us who have committed to heal will be more professionally satisfied and will be better compensated because Americans will really get what they paid for and will sincerely appreciate it.

Sick Care, You Get What You Pay For

In America it generally holds true that you get what you pay for. When you pay more for something you get more of it. How about health care?

As a nation we spend about 16% of our annual income, our gross national product, on health care. That’s more than all other countries spend. Are we getting more health care for all the money we spend? Then again do we really want more health care?

Health care is a service just like tax accounting. Receiving the service may not feel very good but in the end if it’s done well we appreciate the outcome. In the case of our accountant we receive a well prepared, unlikely to be audited, tax return. Our health care providers perform tests, treatments and give advice but ultimately what we really want is good health, not health care. So are we getting what we pay for?

Unfortunately, despite the fact that we spend more on health care than anyone else, by many measures we are not any healthier. American’s life expectancy does not lead the world and because of obesity, smoking, alcohol, drug addiction and other lifestyle issues we are not the healthiest nation on earth. In fact, we currently rank 42nd in life expectancy behind other less affluent, less developed countries.

Health for sale?

So does this mean the basic economic treatise of “you get what you pay for” doesn’t hold true for health care. Actually, it does, it’s just a matter of what you measure.

In America, physicians, hospitals, pharmaceutical companies, medical equipment suppliers, virtually everyone in the “health care food chain” all benefit financially when they do more to us or sell us more stuff. Sadly, they benefit financially when we are sick, not when they lead us to good health.

Think about it, when was the last time you sent a hospital a thank you card and a check because you were still healthy four years after they did your cardiac by-pass surgery? Did you send the company that provided you with the antibiotics for your cough an extra $10 this week because you were still feeling great? And most importantly did you give your family doctor a bonus at the end of the year because he got your blood pressure under control and you didn’t have a stroke?

In all of these cases they would be financially better off if you weren’t feeling well so they could get paid to take care of you again.

It may seem crass but the truth is we have a sick care system, not a health care system. For the most part everyone in the system gets paid more when we’re sick and less when we are healthy. And as sick care consumers we’re also at fault in that we continue to pay for products and services regardless of whether in the end they make us healthy.

So how do we convert a sick care system to a health care system? Well for the next several days, exercise, eat a healthy diet and enjoy a safe Labor Day Holiday . . . then return to Mature Market Experts for my prescription for our sick care system!

The Doctor Is In!

Dr. Gary Applebaum, M.D.
Dr. Gary Applebaum, M.D.

I’m pleased to announce we have a new teammate on board Mature Market Experts. Dr. Gary Applebaum, M.D., is not just one of the nation’s premier experts on geriatrics; he has also been a valued friend over the last 16 years.

I met Gary at Erickson Retirement Communities, where he was the first physician hired by Erickson to practice at Charlestown, its initial Continuing Care Retirement Community (CCRC) in Catonsville, MD; at that time housing 400 seniors. Over the past 16 years, he was responsible for growing a one–physician practice into the Erickson Health system that currently provides comprehensive health and wellness services to 18,000 seniors residing in 16 Erickson communities in 8 states. For his efforts, Gary was named Geriatrics Clinician of the Year by the American Geriatrics Society in 1994 recognizing the unique nature of the system of care developed at Erickson.

So you can see why I’m excited about having the good doctor on board. When he blogs about the mature market, he knows what he is talking about (Gary testified at a congressional hearing for the United States House of Representatives, Select Committee on Aging’s subcommittee on long-term care).

As Executive Vice President and Chief Medical Officer of Erickson Retirement Communities, Gary developed and managed the largest group practice (Erickson Health) of geriatrics providers in America. Erickson Health is recognized for providing care that is Accessible, Appropriate and Affordable for seniors. Currently, Erickson Health is staffed by 55 physicians and 30 advance practice nurses providing over 50,000 primary care visits/year with a budget that exceeds $20 million a year.

He also developed and provided medical direction to all services of the Erickson Health system including but not limited to: skilled nursing care, assisted living, rehabilitation services (PT, OT, SLP), pharmacy services, mental health, home health, podiatry, dentistry, numerous medical specialties, emergency medical services, and health clubs. Virtually all medical needs short of tertiary acute care are available at a fully developed Erickson community.

Gary lead the installation of Centricity (GE Health Care), a primary care electronic health record system, in less than a year at 10 practices in 7 states including data entry of over 10,000 patients’ charts. To accomplish this, the team needed to train over 200 providers and staff members to use system. Erickson’s practices are now paperless including all medical documentation, as well as prescriptions and billing. I have long considered electronic medical records essential to improving the U.S. health care system forward.

Most importantly, Gary loves seniors. Currently, he continues to practice medicine at Levindale Hebrew Geriatric Center and Hospital. He is also a partner and investor in an early stage venture capital fund, Nobska Ventures. In addition, he recently joined the team at TR Mann Consulting.

As many of you know, I have long loved Tom Peter’s rants on what’s wrong with American health care. The beauty of Gary is that he brings Tom’s anger and adds gasoline to it with a powerful dose of insider’s knowledge and real solutions to make things better.

This is going to be fun!

Leading Senior Experts Consortium Continues To Grow

And now, a word from our sponsor: TR Mann Consulting. Boomer / Senior / Mature Market Stat of the Day – The numbers are staggering.

In 2010 the 65+ population will be at roughly 40 million, quickly rising to more than 54 million by 2020. When you consider these are the people who hold the bulk of the country’s money and are undergoing significant life changes, they will drive the lion’s share of our economy. To prepare for that, I’ve put together a strategic all-star team of mature market experts. This unique team makes us an incredibly different marketing team.

TR Mann Consulting has recently added Gary Applebaum, M.D, Geriatrician, one on the country’s foremost experts on geriatrics; Marks, Thomas, Architects designer of some of the nation’s finest retirement communities; David Weilgelt of Immersion Active, leaders in on-line marketing to seniors, and Anirban Basu, the founder of Sage Policy and Chief Economist of the Associated Builders and Contractors (national).

Here’s a little more dirt on my new teammates:

Gary Applebaum, M.D, Geriatrician

Currently, Dr. Applebaum continues to practice medicine at Levindale Hebrew Geriatric Center and Hospital. He received his M.D. from the University of Pennsylvania, trained at the Johns Hopkins University and is board certified in Internal Medicine and Geriatrics. He is also a partner and investor in an early stage venture capital fund, Nobska Ventures. A winner of the prestigious honor of National Geriatrics Clinician of the Year, Dr. Applebaum is one of the foremost experts on geriatrics. Mr. Applebaum established the Erickson Health system for Erickson Retirement Communities and has testified at a congressional hearing for the U.S. House of Representative, Select Committee on Aging. Gary is extremely talented at helping companies set up continuing care retirement communities, assisted living and nursing facilities, and health care surveys.

David Weigelt, Interactive Technology

The co-founder of Immersion Interactive, David Weigelt and his team, are leaders in developing on-line marketing campaigns designed specifically for boomers and seniors. They have a proprietary approach to plan, deploy, manage, and optimize an online advertising campaign that effectively targets 50-plus Internet users and uses an extensive database of media publishers to specifically target different groups of mature users. Through ongoing research and testing they have developed a comprehensive set of best practices and an alternative means of delivery that yield higher click-through and conversion rates. And once implemented, they develop unique methods to optimize and retarget your campaign to ensure your best return on ad spend (ROAS).

Anirban Basu, Economist

The founder of Sage Policy, Anirban Basu is one of the Mid-Atlantic region’s most recognizable economists, in part because of his consulting work on behalf of numerous clients, including prominent developers, bankers, brokerage houses, energy suppliers and law firms. On behalf of government agencies and non-profit organizations, Mr. Basu has written several high-profile economic development strategies. Mr. Basu was also recently named the Chief Economist of the Associated Builders and Contractors (national).

Marks, Thomas, Architects

Marks, Thomas, Architects is one of the nations’ premier architectural firms. They are nationally known for designing environments and communities that have the power to inspire and transform while preserving, conserving and enhancing both natural and built environments for future generations. Their designs promote ecologically responsible, cost-effective, productive and healthy places to live, learn, work and play.

So what do we all do? TR Mann consulting specializes in: selling real estate (condominiums, active 55, retirement communities, continuing care, assisted living, and nursing care); marketing to boomers/seniors; and creating profitable, award-winning media. Each of the partneres in this independent marketing firm has over 15 years experience in their area of focus. Recognized as industry leaders, this team founded the Mature Market Experts which has grown into an international networking group. TR Mann Consulting’s clients range from national publications, like GRAND Magazine, to some of the world’s largest publicly traded builders. In short, if you’re trying to sell or reach the senior market, we’re your team.

 

Marks, Thomas, Architects is one of the nations’ premier architectural firms. They are nationally known for designing environments and communities that have the power to inspire and transform while preserving, conserving and enhancing both natural and built environments for future generations. Their designs promote ecologically responsible, cost-effective, productive and healthy places to live, learn, work and play.

So what do we all do? TR Mann consulting specializes in: selling real estate (condominiums, active 55, retirement communities, continuing care, assisted living, and nursing care); marketing to boomers/seniors; and creating profitable, award-winning media. Each of the partneres in this independent marketing firm has over 15 years experience in their area of focus. Recognized as industry leaders, this team founded the Mature Market Experts which has grown into an international networking group. TR Mann Consulting’s clients range from national publications, like GRAND Magazine, to some of the world’s largest publicly traded builders. In short, if you’re trying to sell or reach the senior market, we’re your team.