This is the last week of our Women in Healthcare series, which we began last month in honor of Women’s History Month. Healthcare Finance News asked some of the women leaders in the nation’s healthcare industry to talk about the role of women in healthcare.
Today, we hear from Diane Meier, MD. An internationally recognized expert on palliative care, Meier, a MacArthur Fellow, is a geriatrician based at Mt. Sinai Medical Center and is the director of the Center to Advance Palliative Care (CAPC). Per her CAPC bio, under her direction, the number of palliative care programs at hospitals in the United States has more than doubled in the last five years. She has published extensively, including as co-editor of “Palliative Care: Transforming the Care of Serious Illness,” a book billed as the first to provide a comprehensive look at the field of palliative care.
Q: What role do women have as decision-makers/leaders in today's healthcare sector?
A: I think that role is increasing exponentially. Just look at the make up of medical school classes in the United States, which are now more than 50 percent women because the entry criteria are based solely on merit. We’ve seen, really, a revolutionary shift in the population. You haven’t seen as much of an increase at the highest levels – the c-suite, deans, department chairs. So I think there are still barriers. Somebody like me has been able to achieve, from the stand point of someone coming at the system not so much from the outside (but) from a disruptive innovation stand point. That is palliative care. (It) is very much a disruptive innovation inside the healthcare system, and because of that I was able to develop a lot of leadership skill going from a palliative care clinician to being someone who is seeking to communicate the benefits of palliative care to diverse audiences using business principles, social marketing principles, healthcare financing principles and using organizational partnership strategies to try to advance the legitimacy of the field with the goal of making sure that every person in the United States that has a serious illness has access to high quality palliative care no matter where they live, no matter how old they are, no matter what their diagnosis is, no matter whether they’re going for a cure or life prolongation, that it just becomes the standard of care.
Q: What do women bring to the table to shape the future of healthcare?
A: There’s been some interesting work done by Carol Gilligan and others about some of the differences in moral development in women – this notion that women have a more heightened sensitivity to the relational aspects of society, of organizations, of working together to accomplish shared goals. That attention to relationship – it’s important, I think it’s critical, to healing our very broken healthcare system because if we don’t work together on behalf of the best interests of our patients we will not be able to help them. The current cost and quality crisis has made that abundantly clear. So while I certainly know plenty of men who have very strong interpersonal relationship skills and plenty of women who don’t, on average, I would say, perhaps because women are socialized this way, perhaps because many of us are mothers, I’m not sure what it is, but I can see that as a common strength among women leaders.
Q: What do you personally believe should be the path forward to better care and lower costs?
A: First of all, I think the path to lower cost is better care. Care right now – one of my colleagues just used the analogy it’s like a subspecialty pinball game. The patient is just bounced from one subspecialist to the next and eventually ends up falling through the cracks and into the emergency room in the hospital. That’s what happens. It’s very poor quality. It’s distressing, confusing, exhausting, scary to patients and families, and it’s incredibly wasteful and expensive. We have a system in which primary care has become so disempowered and so marginalized that patients are essentially victims of excess subspecialization that is very poor quality, and as a side effect, very expensive. If you can restore a universal primary care relationship for patients, if you can improve the power of the primary care sector of the healthcare system by paying people a living wage, making it possible to have a life and a family as a primary care physician, you will see a much higher quality of care and as a side effect, people will not end up in emergency rooms and hospitals and ICUs because they didn’t know where else to turn.
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