by Vernon Rowe
Healthcare and Baseball are alike in many ways, and this similarity was driven home when the Kansas City Royals, against all odds, won the American League pennant in 2014. And again when they won the World Series this year.
Healthcare and Baseball are ponderous institutions, with tremendous inertia doing things the way they have always been done. But occasionally, disruptors can change the way things are done and induce a paradigm shift in the way the game is played for the better.
Jonathan Bush, in his book Where Does It Hurt: An Entrepreneur’s Guide To Health Care, makes this point about healthcare when he says “Health care is starving for efficiency experts, customer service geniuses, retail mavens, people who have created thriving and modern businesses in other industries [disruptors.]”
In the famous Moneyball example in baseball, a paradigm shift occurred in the movie when Jonah Hill showed Brad Pitt (as Billy Beane) the most important part about winning was getting on base. In the movie, John W. Henry, of the wealthy Boston Red Sox , tells Billy Beane: “The first one through the wall…is threatening the way that they do things…and every time that happens–whether it is the government, or way of doing business or whatever it is …the people who are holding the reins, have their hands on the switch, they go [expletive deleted] crazy.”
As the Royals won the American League pennant last year, and gave Royals fans their first postseason appearance since 1985, they did something never before done in the history of the game—8 straight wins to begin the postseason. They did this with a small market payroll uniquely void of high priced sluggers. In an era where home runs are a valued (and expensive) resource, and starting pitchers are thought to determine game outcomes, the Royals’ success has introduced another paradigm shift in thinking to MLB: the ability to run and field and disrupt the rhythm of the game can be as important as hitting.
Though the overall strategy for winning in the postseason may be different from getting to the playoffs, as Judge details in the KC Star, the ability to think and adapt to the play and game at hand, and use every resource in the team’s arsenal, from great fielding to great relief pitching, “to be disruptive,” is critical to winning games. Everyone recognizes hitting is important, but hitting by itself is not enough to win games in either the regular season or post season. That “disruptive” scenario was played out in the fifth and final game of this year’s World Series.
As in the baseball industry prior to Billy Beane, and now the Kansas City Royals, our hospital-centered healthcare system is ponderous, overly expensive, and obsolete. Like the automobile industry of the 1970’s, with its cars gulping gas at the rate of 7 miles per gallon, the healthcare system will need to be re-engineered. The industry itself is sorely in need of disruption.
Most health care is outpatient care, yet most of our healthcare dollar is spent on hospitals–far more than the rest of the world, due to higher rates, not higher volume. MedPAC Study
Independent outpatient centers, like the Rowe Neurology Institute, can be designed to deliver high quality, cost effective care at a fraction of the cost of hospital-based care. This has been borne out time and time again. And the recent budget passed by Congress and Signed by President Obama just this past week reflects this. No longer can hospitals purchase physician practices many miles away from their campuses and double or triple the price of services these practices charge patients for identical services.
These outpatient centers are light on their feet and fast, without facility fees, overcharging, and the weighty infrastructure of overbuilt hospitals dragging them down. They can eliminate long waits and overpricing. Their only loyalty is to their patients. They are disruptors, and in this sense, are game changers and paradigm shifters.
Outpatient centers like these are perfectly poised to disrupt the healthcare system for the better. They have the ability to deliver healthcare to all segments of our population, rural and metropolitan, poor and wealthy, at a fraction of the cost of our hospital-centered, federally-facilitated, healthcare delivery system does today. Just as the ability to steal bases and disrupt the rhythm of the game of baseball, can be a major addition to the arsenal of hitting and pitching. In the now famous words of Jarrod Dyson, a player for the Royals, “That’s what speed do.”
So fast forward one year from that pennant win last year. The Royals are in the ninth inning of the fifth game, and trailing the Mets in that game. This time there was no second-guessing at third base. As the Kansas City Star reported, Cain walked and then stole second base, and Hosmer’s double drove him in. Moustakis’ pull to right allowed Hosmer to advance to third. Then, an out of position third baseman for the Mets caught a looping grounder from Perez when he moved in front of the short stop. As soon as he threw to first, Hosmer sprinted for home. The first baseman’s throw to home was off, and the rest is history. The Royals went on to win in the twelfth.
Baseball is a lot like healthcare. Quick thinking and speedy feet can get the job done, and most times better than huge budgets and weighty institutions. Physicians independent of hospitals play by all the rules, but there’s no report up the line to a CEO businessman with a multimillion dollar salary, before a decision is made to put patients first. That’s what speed, and independence, do.
