What I Learned at ACHE
It’s great to escape the office for a conference—the new ideas, the collegiality, the sense of people getting together to share ideas and solutions is always invigorating. I was especially inspired by last week’s congress of the American College of Healthcare Executives, not least because it was a chance to get out of the radiology mindset and take a peek at the bigger picture. It was hard not to feel as if the future has already arrived. Of course, I tailored my experience to what was most relevant for our readership, attending courses and striking up conversations that largely focused on hospital-physician alignment. But there was no denying that greater alignment, be it through employment or some other model, was already a done deal in the minds of the executives and students in attendance. I mention the students because the executives’ average age is 55, according to one speaker whose session I attended. A decade from now, we’ll be in the hands of the young people I invited myself to sit with at lunch (thanks, guys!), and they won’t even remember a world where specialists like radiologists operated independently from the hospital and brought home big money to do so. The problem, reiterated by almost every speaker, is that it’s already too late to bend the health care cost curve. We’re borrowing 44 cents from China for every dollar we spend on Medicare and Medicaid, and those costs continue to grow exponentially. There’s nothing to do but raise a glass to the crisis, because it’s happening. Our only chance at turning things around is to collaborate like never before—to actually do it instead of talking about it ad nauseum. Bad news? I don’t really think so. We’re not talking about putting doctors on welfare, just about reining in all of the costs associated with mediocre medical care in this country, including very high salaries. And no one was singling out radiologists as the problem. It’s incredible to see, charted out, what denying the SGR update year after year is doing to our costs, and to think about the fact that if all our physicians had just capitulated to it in the first place, the reimbursement drop wouldn’t have seemed nearly so extreme. Getting outside of my usual radiology focus made me realize that our segment of the industry needs to decide right now what it can contribute to reducing costs. We have a small window of time in which to step up as leaders in this new health care world order, but it’s going to take a lot of creativity and a modicum of sacrifice. And the one thing we can’t do is stand our ground and demand that nothing change. It already has changed.