On this episode we talk with Dr. Vivian Lee about her new book, The Long Fix: Solving America’s Health Care Crisis with Strategies that Work for Everyone. Dr. Lee offers a fresh perspective that will strengthen your understanding of the issues facing America’s healthcare system. And while she acknowledges that our government must play a substantial role in driving systemic change, she points out how each of us as individuals, clinicians, payers, and employers all have a role to play. The book’s title suggests that we’re in for a long haul, and I agree. However, Dr. Lee offers concrete examples of driving change in the real world that can have an immediate impact on the work you’re doing today. In particular:
- What it’s like to lead a multi-billion dollar health system into value-based care for the first time?
- Why intrinsic motivators like purpose, autonomy, and mastery are more important than extrinsic motivators like compensation, and how to tap into them to motivate clinicians and drive change.
- How to co-design change with clinicians (and patients).
- How to implement patient satisfaction surveys that actually work.
- How to develop measures that matter, and the surprising things that happen when you do.
- How to track performance to the clinician-level, and the best way to share the data with them.
- Creative ways to reinvest your savings.
I took a ton away from this conversation, and I’m sure you will too!
Dr. Vivian Lee
Vivian S. Lee, M.D., Ph.D., M.B.A, is President of Health Platforms at Verily Life Sciences, an Alphabet company whose mission is to apply digital solutions that enable people enjoy healthier lives. A passionate champion of improving health in the U.S. and worldwide, she works closely with Verily’s clinical and engineering teams to develop products and platforms that support the successful transformation of health systems to value and advance the co-production of health with patients, their caregivers, and communities. She also serves as a Senior Lecturer at Harvard Medical School and Massachusetts General Hospital, and a Senior Fellow at the Institute for Healthcare Improvement. In 2019, she was ranked #11 among the Most Influential People in Healthcare (Modern Healthcare).
She is the author of the acclaimed book, The Long Fix: Solving America’s Health Care Crisis with Strategies that Work for Everyone (Norton, 2020).
Dr. Lee is the former Dean, SVP and CEO University of Utah Health. As a leading healthcare executive, she is committed to the advancement of value-driven transformation in health care (NYT Corner Office, STAT). As CEO, Lee led University of Utah Health to recognition for its health care delivery system innovations (Algorithmsforinnovation.org) that enable higher quality at lower costs (JAMA & editorial, NYT) and with higher patient satisfaction (NYT, HBR, NEJM), as well as successful strategies of faculty development and mentorship. In 2016, University of Utah was ranked first among the nation’s university hospitals in quality and safety (Vizient). Dr. Lee also commercialized the University of Utah’s health plan as Chair of its Board, during which it grew five-fold and was successful in the individual exchange. As Dean, she led the significant expansion of the School of Medicine class size with increased state funding, and helped raise large philanthropic gifts.
Lee is an MR radiologist who developed novel methods for measuring kidney function and vascular disease with MRI. Funded by the NIH for 20 years, Dr. Lee was elected to National Academy of Medicine (formerly, the Institute of Medicine) in 2015, and in 2019, she received the International Society for Magnetic Resonance in Medicine’s highest award for scientific contributions and leadership, the Gold Medal. She served on the NIH Council of Councils advisory to the NIH Director and has authored over 200 peer-reviewed research publications. Presently she serves on the Defense Health Board, advisory to the Department of Defense for military medicine, the Board of Directors of the Commonwealth Fund and the Association of American Rhodes Scholars, the Membership Committee of the National Academy of Medicine, and on the Scientific Advisory Board of the Massachusetts General Hospital. She is also a director on the board of Zions Bancorporation, a publicly traded company.
Dr. Lee is a magna cum laude graduate of Harvard-Radcliffe Colleges, received a doctorate in medical engineering from Oxford University as a Rhodes Scholar, earned her M.D. with honors from Harvard Medical School, and was valedictorian of her Executive MBA program at NYU’s Stern School of Business.
The Long Fix
It may not be a quick fix, but this concrete action plan for reform can create a less costly and healthier system for all.
Beyond the outrageous expense, the quality of care varies wildly, and millions of Americans can’t get care when they need it. This is bad for patients, bad for doctors, and bad for business.
In The Long Fix, physician and health care CEO Vivian S. Lee, MD, cuts to the heart of the health care crisis. The problem with the way medicine is practiced, she explains, is not so much who’s paying, it’s what we are paying for. Insurers, employers, the government, and individuals pay for every procedure, prescription, and lab test, whether or not it makes us better—and that is both backward and dangerous.
Dr. Lee proposes turning the way we receive care completely inside out. When doctors, hospitals, and pharmaceutical companies are paid to keep people healthy, care improves and costs decrease. Lee shares inspiring examples of how this has been done, from physicians’ practices that prioritize preventative care, to hospitals that adapt lessons from manufacturing plants to make them safer, to health care organizations that share online how much care costs and how well each physician is caring for patients.
Using clear and compelling language, Dr. Lee paints a picture that is both realistic and optimistic. It may not be a quick fix, but her concrete action plan for reform—for employers and other payers, patients, clinicians, and policy makers—can reinvent health care, and create a less costly, more efficient, and healthier system for all.
Links and Resources
- Episode 139: Behavioral Economics Expert Explains How to Drive Massive Change with Minor Tweaks w/ Karen Horgan
- Episode 098: Taking Aim at Phony Doctor Reviews w/ Ted Chan
- Episode 079: HCAHPS and the Patient Safety vs. Patient Satisfaction Conundrum w/ Christine Greene and Maurits Hughes from HITS2018
- Book: Drive: The Surprising Truth About What Motivates Us by Daniel Pink
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