Porter Posits Healthy Reforms

Physicians need to start worrying less about the affordability of their health services and more about their quality, Harvard Business School (HBS) Professor Michael E. Porter said in a recently published paper.

In “How Physicians Can Change the Future of Health Care,” Porter and University of Virginia professor Elizabeth O. Teisberg criticize the U.S. health care industry’s preoccupation with cost-reduction.

Instead of competing over the cost of care, health care providers should compete over the quality of care, Porter and Teisberg argue in their paper, published in the Journal of the American Medical Association last week.

Unlike initiatives that seek to improve the health care industry by changing the insurance system, this proposal focuses on the actual delivery of health care,

“If you fix insurance without delivery we may end up in an even bigger mess,” said Porter. “If we have 50 million people seeking care, that will simply compound the problem.”

Dean for the Social Sciences David M. Cutler ’87 praised Porter’s theory of health care competition.

“He focuses on how competition has not served consumers well, but how it might do so if we focus on competition over treating conditions well,” Cutler wrote in an e-mail. “This is a very appropriate message, and one well worth stressing.”

Porter and Teisberg’s paper also suggests that treatment strategies should prioritize patient conditions over physician specialties and that providers should keep diligent records of treatments results and adjust subsequent care accordingly.

Porter and Teisberg, who is a former Harvard faculty member, have been studying the health care system for about 15 years.

“At the time we got started,” she said, “my eldest son had a serious heart anomaly and I got an up-close and personal look at the health care system. My younger son was later chronically ill for eight years and went undiagnosed for six years.”

Frustrated by that experience, Teisberg saw an opportunity for reform.

“The paradoxes in the system are simply amazing. I study innovation, and when you see paradoxes of that magnitude you know the possibilities for innovation are amazing.”

Porter and Teisberg directed their article towards physicians in an effort to call them to action.

“Reform doesn’t have to be a top-down government intervention,” Porter said. “Each part of the system can start to move in this direction without having to wait.”

Their policy recommendations have already been put into effect in several hospitals across the country, including the Cleveland Clinic in Ohio, and the Dartmouth-Hitchcock Medical Center in New Hampshire.