Thursday, November 2, 2017

Retail Therapy

The cliches of health care policymakers have entered a new era of absurd.

A lot of meaningless jargon is tossed around in hospitals and other health institutions on a daily basis. When you're busy at work and you hear it, there's a tendency to just roll your eyes, or perhaps cut the speaker off in frustration if you're having a bad day. Once in a while, though, the verbal diarrhea gets so profuse, you have no choice as part of the audience but to point out that if it doesn't stop, everyone will drowning in s**t.

Just days before we were all distracted by Bernie Sanders' rock-star treatment in Toronto, Health Quality Ontario held its Health Quality Transformation conference, a gathering of policymakers, power brokers, and leading thinkers, to share ideas, inspire one another, pat themselves on the back, and bask in the glory of their mutual success. As I followed the event on social media, I was reminded of a memorable scene in The Big Short, in which Steve Carrell's character can't stop interrupting the self-congratulatory speech by a trader in complete denial of the looming crisis.

Indeed, without a hint of irony, an Assistant Deputy Minister stood before a room of politicians, researchers, and administrators, and declared the convention hall to have "the best view" of health care in Ontario. It's a perfectly fine statement, assuming one is capable of forgetting that most of health care is tending to the immediate needs of people. But the Gold Medal for Absurdity must be awarded to Deputy Minister Dr. Bob Bell, who declared a need to improve upon the "retail experience" of health care.

Say what?

Let's set aside the obvious, namely that health care bears no clear resemblance to retail. And let's further overlook the fact that every other MBA school fad - LEAN, Six Sigma, Toyota Way - has made no noticeable difference in the quality of our health care, the health of the population, and certainly not in the ever-louder drumbeat of budget constraints. Instead, let's grant that health care is a retail industry. How exactly should we improve upon it, as compared with other successful retailers?

Should we be emulating Costco, encouraging people to consume much more health care than they need? Which, by the way, we apparently do a fine job of already.

What about Wal-Mart, with angry crowds, staff struggling in miserable working conditions, and a religious devotion to penny-pinching with little regard to quality of service? Yeah, we're doing well on those counts too.

Or maybe we should look at Home Depot, where you're left to your own devices in a massive and labyrinthine facility? Where everyone that works there is too busy, and you wait for eons to get served? Health care's got an excellent track record there as well.

I know! Canada should take its lead from boutique retailers in reforming health care! Those places where people with money and connections get their rear ends kissed, and everyone else is treated like dirt. Oh, right.

At what point do the Powers That Be stop pretending that everything is sunshine and smiles with our health care system, and asserting that all we need is better leaders, better management, and better data, and Canada can show off its gleaming health care Utopia...a health care system that's (by some miracle) equitable, timely, cost-effective, evidence-based, patient-centered, state-of-the-art, data-driven, population-focused, hospital approved, clinically tested, no money down, no interest, no payments for six months, no strings attached...

Sigh. Does somebody know how late Costco is open on Saturdays in November? I bought the wrong size of yoga pants for my kid.

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