Monday, November 17, 2008

In Search of Excellence – An Individual’s Version

I received this story in an e-mail group that I am subscribed to, and the entire credit for it goes to original author, whoever he/ she may be. But I do think that this is an excellent read for all of us, and a good reminder of why some people are driven to be the best by doing their best.

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A man once visited a temple under construction where he saw a sculptor
making an idol of God. Suddenly he noticed a similar idol lying nearby.

Surprised, he asked the sculptor "Do you need two statues of the same idol?"

"No," said the sculptor without looking up, "We need only one, but the first one got damaged at the last stage."

The gentleman examined the idol and found no apparent damage.

"Where is the damage?" he asked.

"There is a scratch on the nose of the idol." said the sculptor, still busy with his work.

"Where are you going to install the idol?"

The sculptor replied that it would be installed on a pillar twenty feet high.

"If the idol is that far, who is going to know that there is a scratch on the nose?" the gentleman asked.

The sculptor stopped his work, looked up at the gentleman, smiled and said,"I will know!"

The desire to excel is exclusive of the fact whether someone else
appreciates it or not. "Excellence" is a drive from inside, not outside.

Excellence is not for someone else to notice but for your own satisfaction and excellence.


 

Friday, November 14, 2008

Comparison Shopping Healthcare Services

These days we hear about consumer education, availability of options, quality of care data etc. that if made available to the consumers, would lead to better choices and lower costs, because the consumers would theoretically be able to shop around for the right medical care according to their needs and their means. While conceptually, the idea is appealing and almost irrefutable, there is a fundamental reason why this has not happened.


 

I have come across people comparing shopping for a TV to shopping for Medical Care. Conceptually it is a simplistic comparison and should apply equally to Healthcare. But there is a fundamental difference that is overlooked in the comparison – when we buy a TV, we are buying a bundle of size, features, style, brand, quality and reputation and we pay one price for the entire bundle. When we buy medical care, we buy a bundle of outcome, quality of care, peace of mind and wellness, but we pay not for the bundle, but for individual services that go in creating the bundle. Now imagine having to pay for all the components that go in making the TV and all the activities that anyone performed in making the TV. Imagine wading through this detailed component level cost data and process cost and comparing one TV model vs another and trying to come to a conclusion on which TV to buy.


 

I am sure, not matter how much component level cost information is made available to the buyers of the TV, comparison shopping at that level does not make sense. So is the case with healthcare. Procedure level pricing and costing is not going to simplify the comparison and buying process. Treatment bundles need to be created, costed and priced for consumers to really make a meaningful choice. This is different from an Outcome based pricing, and in many ways is the middle ground between Procedure based pricing and Outcome based pricing that might just be workable.