Putting Values at the Forefront of Health Care

Heart in the hand of a doctor and heart rate displayed across image.

Health care operates on a fine balance between business and service. The mantra "No Margin, No Mission" is often used to emphasize the importance of financial sustainability in fulfilling a hospital's commitment to patient care and community service.

While it's true that fiscal health allows hospitals to undertake activities like investing in technology, obtaining necessary equipment, recruiting personnel, and adapting to evolving health care demands, it's important to remember that health care is about more than just the bottom line. 

Beyond the Bottom Line

Consider the case of Martin Shkreli, the former CEO of Turing Pharmaceuticals. In 2015, he increased the price of a life-saving drug from $13.50 to $750 per pill virtually overnight. This action went against the value of patient access and affordability in health care. It's a stark example of the potential harm a narrow financial focus can inflict.

Fixating on financials can obscure the broader vision and undermine the intrinsic human-centered values in health care. We know all too well the negative repercussions that can occur when economic pressures lead to cutting corners, reducing staff numbers or compromising quality. 

The true mission of health care extends beyond economics; it centers on preserving health, saving lives and serving communities. Financial stability should not be an end goal but a means to serve patients and communities better.

Embracing Values-Based Care

To achieve its full potential, a health care organization integrates values into every aspect of its operations - a concept often overlooked in our profit-driven world. 

Value-based care is a common concept that centers around cost-effectiveness and outcome measures; however, "values-based care" takes it a step further by emphasizing the fundamental ethics and principles at the core of health care, such as compassion, benevolence, service, and respect for individual dignity. 

Recently, there has been a growing call from advocates to prioritize values in health care, a notion that has long resonated with clinicians. Values-based care underscores the importance of aligning leadership and decision-making with our greater beliefs and ideals, building trust and a more responsive care environment.

A hospital that ensures access to necessary treatment for all patients, regardless of their socioeconomic status, exemplifies values-based care by upholding the principle of health equity. It's also reflected in efforts to improve the care experience, respect patient autonomy, and ensure that care teams have the resources, time, and support necessary to provide optimal care. 

Positioning values at the heart of health care is a practical strategy that can result in a stronger health care system. These values can help guide organizational priorities and ensure that the system meets the needs of those it serves. Perhaps a more nuanced but equally compelling mantra should be "No Values, No Vision."

The Real Return on Investment

Values-based care places people over profits, ethics over expedience, and service over self-interest. It urges leaders to focus on long-term goals rather than short-term gains and helps organizations to remain faithful to their mission, even in the face of financial pressures or market dynamics.

The focus on values doesn't mean compromising the financial viability of health care organizations. On the contrary, it might help boost the bottom line. Research indicates that improving the care experience creates patient loyalty, increases referrals and improves fiscal performance.

Furthermore, values-based leaders generate a sense of purpose, prioritize team well-being, and establish an inclusive work environment grounded in mutual respect. These leadership traits correlate with increased physician engagement, lower burnout rates and enhanced job fulfillment.

Therefore, making decisions based on the well-being of patients and clinical teams, even when those choices appear at odds with immediate economic interests, can paradoxically lead to financial success in health care.

Charting the Future Course

As we navigate an uncertain future marked by escalating public demand, resource constraints, and a rapidly changing health care landscape, values-based care becomes more critical than ever. Ultimately, embracing values allows organizations to stay true to their mission — providing high-quality, compassionate patient care and serving communities to the best of their abilities.

A Call to Action

It's time to shift from a narrow focus on margins to a broader perspective that encompasses real values. We need to incorporate values-based care into daily practice and advocate for a people-first approach within our organizations.

We can shape a future where financial sustainability and commitment to service are not mutually exclusive but coexist, paving the way for a more effective health care system.

Here are some practical steps that health care leaders can take to promote a values-based culture:

  1.  Develop a Clear Vision: Define what values matter to your organization and how these translate into daily operations and decision-making processes.
  2. Engage Stakeholders: Involve your team members, patients, and the community in the conversation about your organization's mission. Foster open dialogue and invite feedback to create a sense of shared ownership and commitment.
  3. Lead by Example: As a leader, embody the values you advocate. Your actions speak louder than words and can influence your team's behavior.
  4. Promote Continuous Learning:  Encourage staff to learn and always improve. Provide training on empathy, teamwork, and communication. Recognize and reward staff who demonstrate these values.
  5. Evaluate and Evolve: Regularly review your organization’s adherence to its values. Use patient feedback, staff surveys, and performance data to identify areas of success and for improvement. Evolve and adapt based on these insights.

The transformation to values-based care will not happen overnight. It requires time, patience, and commitment. But the potential rewards—for patients, communities, health care teams, and organizational performance—are immense.

So, let's take steps forward and reintegrate values into health care. Let's aim for a system that genuinely prioritizes the well-being of the people it serves and, in doing so, ensure that our core values remain at the very heart of health care.

  • Additional Readings

    Correlation between hospital finances and quality and safety of patient care. Akinleye DD, McNutt LA, Lazariu V, McLaughlin CC. PLoS One. 2019 Aug 16;14(8):e0219124. doi: 10.1371/journal.pone.0219124. PMID: 31419227; PMCID: PMC6697357.

    Patient experience and hospital profitability: Richter JP, Muhlestein DB. Health Care Manage Rev. 2017 Jul/Sep;42(3):247-257. doi: 10.1097/HMR.0000000000000105. PMID: 27050925.

    Compassionomics: Hypothesis and experimental approach. Trzeciak S, Roberts BW, Mazzarelli AJ. Med Hypotheses. 2017 Sep;107:92-97. doi: 10.1016/j.mehy.2017.08.015. Epub 2017 Aug 12. PMID: 28915973.

    Physicians' Ratings of their Supervisor's Leadership Behaviors and Their Subsequent Burnout and Satisfaction: A Longitudinal Study. Dyrbye LN, Major-Elechi B, Hays JT, Fraser CH, Buskirk SJ, West CP. Mayo Clin Proc. 2021 Oct;96(10):2598-2605. doi: 10.1016/j.mayocp.2021.01.035. Epub 2021 Sep 15. PMID: 34538425.




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