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Futurist: Plenty of change needed

Goldsmith

Modern technology – phones, faxes, e-mail, Web sites – must be utilized better to cut down on wasted time, paper and money in the United States health care system, says health care futurist Dr. Jeff Goldsmith, who brings his vision to College Misericordia on Thursday.

And using technology such as e-mail smartly rather than sitting in waiting rooms also can help patients have better relationships with their doctors, he said.

Goldsmith is president of Health Futures, a Charlottesville, Va.-based firm that specializes in corporate strategic planning and health care forecasts. His experience includes time as a lobbyist for the University of Chicago Medical Center, a doctorate in sociology, and a professorship at the University of Virginia’s School of Medicine. He develops his forecasts on a vast web of health care industry contacts and extensive research.

Goldsmith has his hand on the pulse of the health care industry, which he compares to China.

“Our health system is the size of the Chinese economy and growing at a comparable rate,” Goldsmith said. “We have an open cash register and an unlimited appetite for services. We’re not making value-for-money decisions when it comes to using health care; we’re using Dad’s money.”

He makes the point by citing the popularity of MRI scans: Are they popular out of necessity or want? Even if a consumer pays $20 to get an MRI scan, the remaining $980 cost is paid for by others, including those in an insurance plan.

And when it comes to doctor’s office visits, Goldsmith said the current situation of paying for a doctor’s time is on the way out the door. He calls the pay-per-visit method a “taxi-meter approach.”

Patients are ready to update the way they work with their doctors, he said. The days of meaningful one-on-one interaction with physicians have been gone for a while – but can be revived with the skillful use of modern technology.

“What are we looking for when we visit the doctor? We are looking for knowledge and the tools to help us get better. We can use the phone, Internet, e-mail. Why pay $70 to go sit in the guy’s office?” Goldsmith said.

He compares doctor visits to the way people use the Internet: people can visit a Web site for free, but to get more valuable information on some sites, a fee is charged.

“It’s goofy to pay for (doctor) visits only. We ought to be paying for content. I like the idea I can get a response in 10 minutes instead of waiting two weeks for an appointment. People want dialogue and a relationship with their doctor and they are not getting it now,” Goldsmith said.

He argues for better use of doctors’ time, saying doctors really want to spend more time on patient care, but with current billing practices they spend half their time doing other things to help keep the office running. The same holds true for nurses in most offices, he said.

“What do you think the nurses are spending most of their time on? They’re alligator-wrestling with Blue Cross over how to get your visit paid for,” Goldsmith said.

Better to put the nurses to work helping with connectivity to patients, he said. And it’s time for insurance plans and Medicare to get rid of all the paperwork involved with reimbursement. It costs 10 cents to process an electronic medical claim, he noted; $50 for paper claims. Electronic medical claims also make payment to the doctor much quicker.

Each segment of the health care system needs to adapt in order to operate more efficiently, he said. Change needs to happen at all levels: consumers, insurance plans, doctors, hospitals.

“Everyone needs to bear a portion of the cost. The Feds can help out. That’s a big piece of the problem,” Goldsmith said. “We’ve got some work to do.”

Other topics he will address include underlying technologies, turbo-charged diagnoses, remote patient monitoring and electronic medical records.

He looks forward to the visit to Northeastern Pennsylvania, where his visit is sponsored by College Misericordia’s Health Care Advisory Council – a council made up of health care leaders representing a broad spectrum of the industry.

“There’s usually a lively discussion,” Goldsmith chuckled.

Dr. Joe Grilli, director of the health care lecture series at College Misericordia, said Goldsmith’s visit is the first of a series titled “It’s Alive! Bold Predictions for the Future of U.S. Healthcare.” The advisory council developed the series of workshops, speakers and symposiums to spark discussion on important health issues, particularly in Northeastern Pennsylvania.

“Dr. Goldsmith is difficult to get. He’s one of the premier internationally known health care futurists,” Grilli said.

Co-sponsors of the event are Blue Cross of Northeastern Pennsylvania and Geisinger Health System. Corporate sponsors are Moses Taylor Hospital, John Heinz Institute of Rehabilitation and Pride Mobility.

IF YOU GO

Who: Dr. Jeff Goldsmith, health care futurist

When: 8 a.m. Thursday

Where: College Misericordia, Dallas Township

Cost: $15, which includes a continental breakfast. There is limited seating; to reserve a spot, call 674-3020.

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