Hospitals Are The Gimbels Of Healthcare

Today Joseph Babaian (@JoeBabaian) asked my opinion on the post entitled, “Bigger Hospitals Mean Bigger Hospitals with Higher Prices. Not Better Care” posted on The Healthcare Blog. (click here to find the original article)

My simplistic answer in a 140 characters was the following:

Response 1: It’s a multifactorial issue: Culture (people), Process, Technology. Getting bigger = integrate into right cultures of action.

Response 2: In my opinion, CEO’s may be wrong. Hospitals are like department stores; big, slow, difficult to access, expensive. Consumers want amazon.

Here is the big box hospital:


How many people really enjoy or want to go to the hospital? I bet it is close to zero. They are big, scary, usually difficult to get to, park, and figure out where you need to go for your appointment. Not to mention you get bounced from one appointment on one floor to another appointment on another floor, across the facility, and may get lost along the way. Not to mention having to fill out, repeat, and waste your own time doing the same form time and time again.

Reminds me of a big department store. I remember the days in which we would make it an event on the weekend to go to Dayton’s or Gimbel’s. We got in the car. We drove a long distance. We found a place to park. We walked, and walked, and walked. We spent all day looking for items. The prices were always higher. By the end of the day, people were cranky and tired. Then we had to drive home. Bleh.

Sounds like big box hospitals.

Today we love Amazon and Retail stores. We love being able to shop in the convenience of home. When we want, how we want, and be able to buy just about anything and have it shipped to our front door. If we need to see it, touch it, feel it we then hop in the car and drive down the street to the retail store. We pick up our produce, look at our consumer electronics, grab some deodorant, get the oil changed, and home we are in about 45 minutes.

Sounds like what we all want healthcare to be, but isn’t. Well at least in the US.

Here is what healthcare looks like in India.

hub and spoke

In India they too have large hospital (hubs) which do the big major surgeries and complex care for patients.

However, it is the clinics (spokes) which are close to the patients and families that do the majority of caring for patients.

Let’s think of a cancer patient.

You may go to the local clinic to see your physician for a routine annual physical. You may have a mammogram performed there. That mammogram is read at the central hub. If there is something found that is suspicious, then the hub generates the next steps and communicates with the clinic (spoke). If follow up is needed for a biopsy, then a patient goes to the hub. The hub has the capabilities to do the additional workup, diagnosis, and surgery that is needed upon a positive diagnosis.

When it comes times for the rest of the treatment, such as chemotherapy, the patient receives it close to home again in the clinic.

Let’s think about this for a moment.

The majority of the care a patient needs on a routine basis either on the screening  side or on the treatment side of the care spectrum happens close to home. close to a patients support system. There is minimal investment for the clinics other than the labor.

When it comes to the complex diagnostics and interventions, which only happen once or twice during a care cycle, the work is performed in a larger hospital hub. The hub then has all of the expensive technology and medical devices, the higher priced labor, and the continued expertise in caring for patients due to the higher volumes.

So this lowers the overall costs of care, investment needed, and concentrates on ensuring that the utilization and capacity of those investments are running as high as possible. Not to mention that the specialists have enough volume of patients to continue to keep their skills refined.

India may be an emerging country, but perhaps the care model and patient experience is one we need to steal like an artist and improve our healthcare story?

Do any of us want to go back to the days of mail order catalogs versus instant gratification?

Come on healthcare, catch up. This is the story we want.

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek


#PtExp #PX #cancer #hcldr #hccosts #hcsm #stories #storytelling #lcsm #bcsm #hcmktg #mktg #storyteller #hcpt #consumerism #hcbiz #CX #UX #Bioethx

3 responses to “Hospitals Are The Gimbels Of Healthcare

  1. Andy — Good post. Also there is good news; there actually is a trend towards the model you describe in your post here in the US. More and more hospitals have community “outposts” with primary care and specialty docs. Close by, in the same medical complex, sometimes in the same building are the requisite imaging and diagnostic centers allowing for one stop Doc, X-ray/CT/MRI, and blood test “shopping”. Many also have community centers for outpatient procedures such as colonoscopies. My husband did all of his CT scans and MRI’s, blood work, onc visits and chemo locally. He only went to the hospital for his biopsies and PET scans and for expert consults (Dana Farber and Yale). We need to be watchful of how this model is impacted by the trend for more docs to become hospital employees. As long as hospitals buy up local practices and leave them in the community identified with the hospital brand patients will be able to get Amazon type medical care.

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