National Doctors Day honors the physicians who help save lives every day around the United States. The holiday first started in 1933 in Winder, Georgia, and since then has been celebrated every year on March 30, which was the first anniversary of a doctor using ether anesthesia. Today, we continue to celebrate medical advances like these and thank all of our Bon Secours Mercy Health doctors across our entire footprint who have spent so much time and energy mastering their fields of expertise.
In honor of National Doctors Day 2022, we had the privilege of speaking with Dr. Jimmy Chung, the Chief Medical Officer of Advantus Health Partners and a board-certified general surgeon for 22 years. Our discussion with Dr. Chung centered around the unprecedented challenges the healthcare industry is facing within the healthcare supply chain. Below are Dr. Chung’s insights on how supply chain has matured within health care and how the relationship between physicians and value analysis teams has changed over the years.
It could be said that before 2020 the phrase “supply chain” was almost never heard outside of the logistics, freight, retail, and manufacturing industries. You certainly would not have thought of a supply chain within health care. Then COVID-19 turned the world upside down, and soon after “supply chain” entered the world’s common vocabulary. For health care, the supply chain crisis literally became a life and death situation, with supplies of personal protective equipment (PPE), ventilators, and then vaccines unable to keep up with the patients who desperately needed them. Like never before, doctors were forced to think about what they need on a daily basis to do their jobs effectively. Supply shortages, irrational purchasing, and logistical challenges stemming from the current labor shortage began disrupting the health care supply chain.
In the past, physicians were invited to participate in value analysis processes or supply chain initiatives to collect their opinions and guidance in terms of what’s clinically valid. That was the limit of our involvement in supply chain decisions. Today, more physicians are represented in supply chain leadership roles than ever before. We are now an integral part of the incident command meetings that occur nearly every morning inside hospitals and health networks across the country, and are very much aware of how much PPE we actually have in stock and how that PPE should be distributed. Physicians are now involved in analytics and clinical scenario planning, such as whether N95 masks or respirators should be used, or how a hospital is going to repurpose operating rooms as ICUs.
Those who manage value analysis now see physicians, clinicians, hospitals, and vendors as collaborative partners, or better yet, customers. If health care can continue to envision this sort of construct, the clinically integrated supply chain will change dramatically, leading to a standardization of care. In health care delivery, the highest value and best outcomes for a patient should be standard, which means the unnecessary variability within physician practices should be removed and standardized towards the best practice based on evidence and data. When a collaborative and clinically integrated supply chain is built, there is a conviction to work with all stakeholders to standardize towards what is the best practice and what will lead to the best patient outcomes using data and evidence-based medicine. It’s a big cultural change, but one that will start to happen.
Looking forward, it will be important for physicians and hospitals to share data across the entire industry. This may be where suppliers can help. If thousands of surgeons across the country or around the world are using different products and getting similar outcomes, then there really isn’t a difference between manufacturers or devices when it comes to clinical quality. Let’s use this type of data more when speaking with clinicians. It’s okay for a value analysis professional to challenge a physician to bring data to the supply chain conversation. In fact, this is a conversation that Advantus Health Partners has been having with physicians to ensure that there is a level playing field across hospitals and health networks.
Another item we should consider when looking forward is making sure the industry has a clear understanding of what value-based care means. In general, it means care is reimbursed based on keeping patients healthy and not necessarily doing a lot of cases. Some value-based care models include Population Health capitation and bundles, which means being responsible for providing the highest value care to the patient. That doesn’t mean, “don’t do a surgery.” First, the physician needs to decide if surgery is right for the patient. The cost of surgery is one important factor. But what might be more important to consider is waste. Surgery can be very expensive, but if it was necessary and it was done in the right way, in a way that was efficient, efficacious, and good for the patient, then that creates value. In the end, the surgery was not wasteful. Avoiding waste means reducing variability.
Health care is extremely complex, and there is a lot to learn from outside industries, especially regarding supply chain management. The industry cannot continue to claim, “health care is different,” and reject ideas from non-health care experts. If other industries offer successful supply chain models, health care should look at how that model could be adapted. The first lesson in doing so may be how the industry collectively defines the ultimate and most important customer.
It’s important that physicians partner with supply chain professionals. Physicians also have to understand that they are just one part of a larger team, all of whom share the common goal of optimizing the patient’s experience. One critical role is to speak with other physicians to define the clinical components of the value equation. The best place to start in becoming an effective member of the health care supply chain team might be to become knowledgeable in the areas of health care finance and the science of High Reliability. Physicians interested in supply chain should get involved as team members, ready to learn and see how they can help throughout the entire process.