Relentless Health Value

Eighty-five percent of patient visits happen in the non-acute space. What happens if you don’t provide high-quality services at these non-acute care sites? Patient leakage, for one, which can cost up to something like a million dollars a year to a health system. Another problem with poor quality is poor quality metrics and also patient satisfaction, at least if that poor quality is perceived. Another consequence of poor quality is higher cost per patient for the ones who stick around but haven’t been properly diagnosed or put on the optimal treatment plan.

The National Institutes of Health (NIH) published a study showing how much more patients with undiagnosed conditions and on the wrong treatment plan cost vs those who have been properly treated … and, spoiler alert, it’s pretty significant.

So let’s talk about how to achieve high-quality care efficiently. First off, I’d consider the 50% cohort of patients who a mountain of medical literature confirms receive suboptimal care: women. And if you’re now suddenly thinking about this in the context of a “gender issue,” let’s put that aside for now. Let’s think about it in the context of a business issue.

Women are often described as the CEOs of their household health care. So maybe we should consider not dismissing the concerns of the boss. Also, women are the most likely to go elsewhere for care, taking themselves out of a health care system or the health care system entirely for alternative medical approaches. And it’s tough to provide risk-based care when the evidence basis isn’t actually evidence based for half your patient population. Finally, employers care about the productivity of their talent pipeline, and you can’t be productive if you’re out sick, feeling sick, or taking care of your sick kids or parent.

But here’s the kicker: You know all the talk lately about consumerism and about how millennials are going to shake up the status quo? Millennial women are half of that equation.

Today I speak with Maya Dusenbery, journalist and author of the book Doing Harm.

Maya Dusenbery is a journalist, editor, and the author of Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick. She is editorial director of Feministing.com and has previously been a fellow at Mother Jones magazine and a columnist at Pacific Standard. Her work has appeared in publications like Slate, Cosmopolitan.com, HuffPost, TheAtlantic.com, Popular Science, and Teen Vogue, among others.

03:01 More than 40% of women with an autoimmune disease have been told by a doctor that they are overly concerned with their health.
04:03 Gender gap delays in diagnosis.
05:03 “The knowledge gap and the trust gap.”
06:38 Why autoimmune diseases are so difficult to diagnose.
09:26 Why it’s difficult for patients to trust themselves in their pain and problems.
10:05 Underestimating the authority that medical professionals hold.
13:14 The issues with treating women properly.
14:19 “Women are 50% to 75% more likely than men to have an adverse drug reaction.”
15:10 The remarkable problem that leaves one-half of the population less well treated.
15:49 “The less that we know about women’s bodies … the more that we tend to … dismiss them.”
17:42 “We are poised for change.” —Stacey
19:31 Social media and affecting change.
21:47 Do employers have a stake in this?
24:53 Maya’s advice for health care professionals and systems to better cater to millennial women.
25:14 “… listening to women and believing them.”
26:57 Why millennials are more likely to skip primary care and go straight to a specialist.
31:41 “Nobody … wants their health to become a second full-time job.”
32:12 Health care providers educating themselves on the history of health care and its biases.