Originally opened for the poor is now catering to the wealthy
Massachusetts General Hospital was founded for the poor has announced opening of a concierge medical service. So if you pay $6000 a year you can have immediate access to three doctors, and they hope to get more. They say they can then get you immediate care by specialists in their system.
Southcentral Foundation, in Anchorage Alaska, and the NUKA system of care, is a model healthcare system where the poorest of all have same day access to their primary care physician and have the best care system to keep its 65,000 members out of the hospital. Its members don’t pay a premium for their service, and the Alaska Natives who it serves have gone from having full coverage in a federal system to owning their own system- getting rid of waiting times, and having the best metrics in the world for healthcare.
This is one of the beautiful buildings where customers of SouthCentral receive their care.
No extra charge for this service in what is called the NUKA system of care. But how much does this healthcare system cost? It turns out less per person than any other healthcare model in the world.
This last week I spent a couple of days in Boston and listened to one of their surgeons try to convince some why people should have surgery in the ivory tower (another Harvard affiliate). He had a wide array of specialists available to him that he would call in an instant. But like most specialists operating in an ivory tower, the metrics of their healthcare is not as good as many community centers. They will say it is because they take care of complex cases, but that isn’t proven by their case mix index (a widely available formula to see how complex cases are in the hospital). But perhaps it is because SouthCentral system calls patients “customer-owners” and treats each person that way, not in the paternal “doctor-patient” relationship.
Relationship centered healthcare is not a new idea – several systems have advocated it, but Southcentral Foundation perfected it. So, do you want to be seen by a doctor because you can pay the cash, or do you want to be treated as if you own the facility and need some healthcare? For their work they received the Malcolm Baldrige award for healthcare in 2011
Where would I choose my medical care? I could choose the concierge service – but after spending a couple of days in Boston I am quite happy that my doctor, in Alaska, and to keep my healthcare with the greatest healthcare system in the world, and where the poorest person can see the provider that day.
Mass General (widely parodied as Man’s Best Hospital) is saying they want to serve the rich so they can follow their mission to serve the poor. Do you know that you can ask almost every person who works for SouthCentral their mission and vision statement and they could tell it to you?
Our Mission
Working together with the Native Community to achieve wellness through health and related services.
Our Vision
A Native Community that enjoys physical, mental, emotional and spiritual wellness.
Seems to me Mass General lost their mission and vision the day they decided to find a way to attract the wealthy. Of course their mission statement talks about the diverse communities they serve — apparently they want the wealthy in their diversity. Attracting the wealthy won’t make their system more open to the poor – it will just add revenue to a bloated system that has not changed their healthcare model from the 1940’s. The system needs to change by placing the relationship with their patient’s first – it is clear they are putting the relationship first if you have the money.
Of course, even Harvard is working with the Nuka system of care – learning it. Maybe Mass General should ask the primary care team at Harvard Medical School how to do it.
When it comes to changing healthcare, making it widely available to the poorest of the poor, and having the best metrics in the world – you will find it in Alaska.
