Putting Patients First May Actually Pay Off

Show me a hospital, health system, medical practice or any business in healthcare really, and I’ll show you a set of mission, vision and value statements that puts patients first.

Given that the industry continues to struggle with the old chestnuts of access, cost and quality, more than a few organizations are lying.

How do we know they’re lying beyond the lagging measures of access, cost and quality? Because putting patients first may actually turn out to be a lucrative business model, at least according to a new study in JAMA Health Forum.

Five researchers affiliated with Weill Cornell Medical College, the University of California at Berkeley, the Yale Law School, Boston University and the University of Washington, looked at the correlation between physician altruism and patient outcomes. The researchers defined physician altruism as doctors who put the interests of patients above their own interests. The outcomes were preventable hospital admissions, preventable emergency department (ED) visits and Medicare spending. The study pool consisted of 250 physicians and 7,626 Medicare patients attributed to those physicians.

The researchers determined whether the physicians were altruistic through a voluntary online test in which they could divvy up $250 in real money between themselves and an anonymous other person in 25 different ways ranging from all to themselves or all to the anonymous other person. Using some fancy math, the researchers decided which physicians were altruistic and which ones were not based on how they divvied up the cash.

In a finding that would make a great news story by itself, the researchers found that only 45 of the 250 doctors were altruistic under the study’s definition. That’s just 18%. The other 82% were “not altruistic.”

The best line in the study — which comes after the researchers downplayed the 18% by saying that percentage is much higher than the general population — is this one: “Physicians not characterized as altruistic may have some degree of altruism.” Hysterical.

Germane to this story is the fact that the 1,599 patients attributed to the altruistic doctors had better outcomes. They had 38% fewer preventable hospital admissions. They had 41% fewer preventable ED visits. And they incurred 9% less in Medicare spending.

“Patients of altruistic physicians might have better outcomes because their physicians choose the most appropriate tests and treatments, and/or because altruistic physicians devote more time and energy to their patients,” the researchers said.

Further: “Our results are consistent with arguments that attempts by hospitals, medical practices, Medicare, Medicaid, and private insurers to improve quality and reduce spending should seek ways to increase, rather than decrease, physicians’ intrinsic motivation to put patients’ interests first.”

Doing what’s good for customers is always good for business. It’s a lesson healthcare has yet to learn. If it had, we wouldn’t be having all these access, cost and quality problems all the time.

Thanks for reading.