Redefining Health Care: Creating Value-Based Competition on Results
	Author: Michael E. Porter Published: 2006-05-25
	List price: $39.95 Our price: $24.75	Usually ships in 24 hours As of: September 09th, 2010 07:17:01 AM
Customer comments on this selection. Porter and Teisberg Attempt to Fit a Square Peg into a Round Hole Porter's theories on management are the bread-and-butter of management theory but he knows little about healthcare. It would be fantastic if his elegant theories worked for this industry, but they don't. Serious flaws: Authors: Care value should be measured by outcomes. Reality: This is the fundamental problem with the healthcare market is that even the end-user of cannot fully assess the outcome not to mention the medical interventions' contributions to that outcome. Diseases recur and response to medical treatment varies so greatly that doctors rarely agree on the simplest courses of treatment. Only for the most common disease states will there be consensus on intervention. The authors compare the healthcare consumer to the institutional purchaser of computer systems, people that are generally IT experts. This is akin to comparing all patients to nurses. Authors: Competition should exist at a national level. Reality: Patients are cured locally because sick, pregnant, working people, etc., do not want to travel to another city to get specialized care. In fact, Guy David's studies show that proximity of less than half a mile holds more sway for patients than expertise. One can't purchase healthcare over the internet. Nor can patients in the bottom 50% of wage-earners travel to another metropolitan area every month to see a field expert. Authors: Community-based hospitals repeatedly produce better outcomes than academic institutions Reality: Patients with difficult-to-treat medical conditions are referred to or self-refer to academic medical centers so the sample group is biased. It's no surprise that Porter missed some of the most obvious aspects of defining the problem. The acknowledgements section of the book contains few of the renowned experts in the field. The centers of knowledge do not lie in the management departments of Harvard or Darden. The authors seem to only have corroborated their theories with individuals from other industries, second-rate scholars, and politicians. It was frustrating to have to read 411 pages of repetitive and ignorant text. While Porter has created groundbreaking theories in management (specifically of manufacturing and less-specialized service industries) he is attempting to fit his famous theories where they do not fit. One must admire the attempt to write a comprehensive solution to the problem of the US healthcare system. However, it's an effort fraught with laziness and little introspection. The book, however, has a decent reference section. Either the authors did not read these papers themselves or chose to ignore the most salient points in the works of the field experts. If you want to real scoop, read Halvorson, Pauly, Danzon, Fisher, or anyone else who has studied this field for more than the authors' seven years. Halvorson's Health Care Reform Now is a far superior book because it provides actionable remedies for the health care problem. Furthermore, Halvorson has 30 years of healthcare experience (compared to Porter's 3 years when he wrote this book). In addition, Halvorson has actually implemented his suggestions. Also, he cites credible organizations and publications that actually support his suggestions (RAND, IOM) whereas Porter cites and collaborates with organizations merely willing to collaborate with him (Dartmouth and Harvard - two institutions with very little research and health care specialists). Halvorson's book may not have as thick a list of citations as Porter's; however, it makes its point more concisely and much more effectively than Porter's. In Porter's defense, since writing this book, he has become more knowledgeable about health care and his arguments are starting to make more sense. Redefining Healthcare proves the complexity of health care by demonstrating how difficult it is to apply basic theories of other industries to fix the health care system. Halvorson's book along with R. Lawton Burn's The Business of Healthcare Innovation are the two most valuable books on the American health care system. You can read them both in half the time it will take you to read Redefining Healthcare and you will be twice as knowledgeable. Redifining Health Care The book is in excellent condition, but it took a long time to get mailed to me. What's wrong with the US health care market place? Why doesn't it follow the progression to higher quality and lower prices as most other industries do? These are some of the questions that authors Michael Porter of Harvard Business School and Elizabeth Teisberg of University of Virginia School of Business attempt to answer. The book paints an accurate portrait of the shortcomings of the US health care system, which fails to identify and scale up providers who provide the highest quality health care at the lowest cost. Health care providers, health plans, payers, and consumers are responsible for our low performing, high cost health care system. Real reform of the system has implications for all stakeholders and, optimistically, this reform is already underway. Improvements in health care quality reporting and access to these data by consumers and payers is increasing, providers are consolidating from solo private practices to medical groups wherein health plans are supporting transformations to patient center medical homes that actively manage patient health status through preventive care and case management. Employers are expecting that health plans augment their provider contracting discounts and claims processing with health and wellness programs, including disease management. Health care technology, including electronic medical records and telemedicine, are improving the portability of health information and enabling remote hospitals to instantly access medical specialists at nationally and internationally recognized hospital centers. The authors do an excellent job of highlighting the levers in the domains of each stakeholder that must be switched on for transformation to a value based market place to happen. I argue that it will happen out of economic and technological developments, as well as the influence of globalization, rather than via any significant policy changes, with the exception of a government mandate for individual health insurance coverage that has now been passed at the federal level. Even though I share the opinion of several other reviewers that the book is unnecessarily lengthly and redundant, I do recommend it for its broad viewpoints and substantial supporting case studies. No solutions at all. Received one of the first copies early in 2006. Wanted very much to find and apply their ideas. After re-reading all my highlighted pages a summary produced a BLANK page. Not one solution. Since this involves human life I can not do anything not based upon solid knowledge of cell physiology and economic principles that focus on human nature. The book has many charts that verify the symptoms of our problems. They are not physicians and more importantly do not really understand where we went off-the-tracks. Symptoms are a result of a cause, not the cause. Elizabeth used her own experience but her actions were the opposite of their proposal for us. I had a private practice for 25 years but now consult for companies that want healthy employees. They measure their own health then watch it improve. You must be hands-on with patients to understand what health is. Albert Einstein said, "Experience is knowledge, everything else is just information. I learn from every patient, from healthy people and from every book-------------but not this one. They are economists that do not understand what Frederick Hayak (and many others)have made clear. Read, The Fatal Conceit: The Errors of Socialism, or The Road to Serfdom, or The Constitution of Liberty. To understand how to help others, read: From Pathology to Politics: Public Health in America or The Food and Drink Police: America's Nannies, Busybodies, and Petty Tyrants. When I was a little boy I heard simple theories that sounded like they would work. Often we do find simple solutions but they always come out of an understanding of the complexity of body chemistry and human nature. When it does not work, stop doing it. I wasted several days reading this very bad 500 page book cover to cover. Good try As an avid follower of this space I was excited to see Michael Porter write on the topic. The topic is too wide and I was wondering how much time did Michael Porter spend on studying the field before transposing his competition oriented theory onto healthcare. I was bit disappointed because when I saw the content I knew he didn't study is well enough. Take this for example on page 48- 'Most patients are actively discouraged from seeking and securing the best value care.' Reality is most patients do not seek best value. This coming from a third pary insurer who put up wbesite to compare prices. Insured members just don't use it. Most patients wouldn't be able to distuingish valuable care from punctuality of doctor or courtesy of office staff. Dr.Porter assumed that consumers and supplier behavior is similar as in other fields and has really erred over there. He really had to understand intricacies of our unspoken health beliefs to get this right. Still it's a step in right direction.
Similar Listings Who Killed Health Care?: America's $2 Trillion Medical Problem - and the Consumer-Driven Cure The Innovator's Prescription: A Disruptive Solution for Health Care Critical: What We Can Do About the Health-Care Crisis The Business of Healthcare Innovation A Second Opinion: Rescuing America's Health Care
Our Health Care book picks:
FIRST AID FOR THE NBDE PART 1 2/E (First Aid Series) (Pt. 1) First Aid for My Horse Essentials of Environmental Health Occupational Safety and Health for Technologists, Engineers, and Managers Dianetics: The Modern Science Of Mental Health (English)

Disclaimer:
This site does not treat, diagnose or assess medical conditions. We do not prescribe medication or provide medical advice. The opinions, information and resources contained within this site are for informational purposes only. This information is not medical practice nor medical advice. Before starting any type of medical progam, exercise program, change in lifestyle, or diet, consult your physician to determine the options best suited to your individual needs.