Page 200 - The Drucker Lectures

On Health Care [ 181

account for at least two-fifths of medical transactions and one-
fifth of the health-care money we spend.
At the other end of the scale we have something that didn’t ex-
ist in medical history: things the physician cannot cure, but where
he or she can enable people my age to function, or at least hope to.
This idea, where you can’t cure something, is basically contrary to
the ethos of medicine. That old ski jumper’s knee of mine—no,
you can’t cure it. But you can help me get along with it.
In between, you have the traditional clinical medicine, where
the great scientific advances have been made. This accounts for
maybe 25 or 30 percent of the demands of the system but for far
more of the expenses of the system.
And each of these areas overlap, but they are not the same.
I think you have to design a system that accepts this. So, what
would the health-care center of tomorrow look like? What could
it look like? You may notice that I haven’t called it a hospital
because “hospital,” for most of us, still has the implication of
patient beds.
In my community, there is a very good hospital—480 beds—
and last October I was a patient there; I managed to get myself a
bout of pneumonia. And the hospital administrator came to see
me and I thanked him and said, “George, what are you doing
this morning?” And he said, “This morning I’m on Cardiac In-
tensive Care, and on Orthopedic, and on Pediatric.” And I said,
“Three weeks ago you opened that beautiful MRI Center. Have
you ever been there since?” You know how much he invested in
it, don’t you? But he hadn’t been there. And he got the money
for an excellent regional cancer center. He has never been there.
It’s an outpatient center with chemotherapy and X-ray. He is bed
focused. Yet, when you look at it, 70 percent of his revenues are
in outpatient services. And he has no idea what goes on there.
Literally not. He doesn’t even know how many ultrasounds he
has because that is still left to the individual physicians.