This comes from a Harvard Business Review called The Employer-Led Health Care Revolution. It chronicles Intel’s attempt to save money on healthcare. They did all the hip stuff like on-site clinics, wellness programs, etc but:
While those programs generated improvements in employee awareness, engagement, and accountability, it had become clear by 2009 that they alone would not enable Intel to solve the problem, because they didn’t affect the root cause: the steadily rising cost of the care that employees and their families were receiving.
So, they put their heads together and:
The company decided to tackle the problem as it would a manufacturing challenge: by using lean improvement methods to rigorously manage the quality and cost of its health care suppliers. Intel led a health care collaborative that focused on six clinical processes for treating conditions such as diabetes and lower back pain.
The picture above is the results. Now, what is missing from this picture? Hmmm. There seems to be something familiar that is gone. Hmmm. Oh, yes, the answer is to get rid of the doctors! They must have been the problem all along! Everyone knows that a rehab office assistant or what I like to call a ROA can figure out by phone what to do. What was the medical system thinking? Now this is revolutionary!
I have repeated this over and over again on this site that the ultimately goal by administrators/hospitals/government/employers, in any medical solution, is to get rid of the doctors. This is just another example of many. It makes my back start to ache just reading it. Now I have to go call the ROA. Damn.