Michael Millenson President, Health Quality Advisors LLC and Adjunct Associate Professor of Medicine, Northwestern University Feinberg School of Medicine
Michael L. Millenson is an internationally recognized expert on making American health care better, safer and more patient-centered. The author of the critically acclaimed book, Demanding Medical Excellence: Doctors and Accountability in the Information Age, he is president of Health Quality Advisors LLC and an adjunct associate professor of medicine at Northwestern University’s Feinberg School of Medicine. Earlier in his career, he was a health-care reporter for the Chicago Tribune, where he was nominated three times for a Pulitzer Prize.
I have never had anything bad happen to me personally. My advocacy role is to stir things up, and to say the things that the experts won’t say in public about money, about failure, about ego, and to bring in the evidence-filled literature and the evidence from what happens to people in real life. To stir things up and cause change. That really is somewhere between people telling personal stories, and the guys writing academic articles.
Changing Health Care
Very simple. Grab them by their wallets, and their hearts and minds will follow. Money motivates. People say it doesn’t, but as you can hear every speaker today it does. You have to show people that it’s in their self-interest to change, and then they will change money, publicity, for culture, all that comes down to having people change. People do not change even when they have the best of intentions. Change the payment system, change how people shop, change how people are paid by big third-party payers, change how people are measured, and behavior changes. It’s that simple.
Humanism and Health Care
To me, one of the most important things is not forgetting the human part of healthcare. And that’s why when people talk about patients as consumers, that’s ridiculous. When you’re sick with cancer, you’re not a consumer. People talk about consumerism, empathy, understanding the vulnerability that people have, understanding how you can take care of people as well as empowering people. That’s really the most important thing.
You can’t treat healthcare like it’s an industry, it’s not that. You absolutely have to have the right financial incentives which are just as important as not forgetting to appeal to people’s sense of mission. Just as important as understanding that healthcare is special. That what providers do is truly something that’s holy. And so, while it’s hard on providers, it’s also because it’s a holy mission, and they need to fulfill it. There are two sides, remembering empathy, remembering humanity, and vulnerability of the sick, we can’t forget that as we celebrate data.
Overcoming Challenges in Health Care
One of the most difficult things is waiting for the changes we all know should happen to actually happen. You hear people talking about variability and clinical performance, which was the subject of big congressional hearings and headlines in 1984. When will we change how quickly we change? How quickly will data visibility, payment changes, and culture change what we know have to change? To me, that’s what’s haunting is that there are patients who are hurt and sick and die unnecessarily because we don’t do what we know how to do. Doing what we know how to do today to make care safer, better, more effective, and more efficient. That’s kind of what haunts me and where I hope that will gather momentum.
This interview was recorded at Health Datapalooza 2019 conference