"Letting Go of the Patient"

The quality of healthcare in the Netherlands is improving, but costs are rising even faster, now exceeding 100 billion euros (13.3% of GDP). Labor shortages and absenteeism due to illness are relatively high in the healthcare and social services sectors. There are 1.4 million people working in these sectors, but that is not enough. Many are covering for others, which may explain the extremely high rates of absenteeism. So, this system is failing. A healthcare crisis is virtually inevitable.

Fortunately, the healthcare sector is brimming with initiatives aimed at providing better care at lower costs. Let me mention a few of the larger concepts (by no means an exhaustive list): shared healthcare, appropriate healthcare, shared decision-making, regional healthcare, JZOJP, integrated healthcare, circular healthcare, sustainable healthcare, VBHC, … And there are many hundreds of smaller initiatives. All well-intentioned, but very fragmented.

Scaling up is proving difficult; there’s a lot of “not invented here” mentality, and, as a result, many people are reinventing the wheel. Most improvements aren’t really complicated in terms of content, but we can’t seem to connect them. There are many silos and isolated units in the Healthcare chain. Why doesn’t the Healthcare sector work together?

That’s because of the many “mine/yours” debates. Mine/yours data, mine/yours budget, mine/yours system, …, and behind all that lies “my” or “yours” patient. We say “patient-centered,” but what we really mean is “my patient.” In our own silo. Responsibility for the patient—the Hippocratic Oath—has institutionalized compartmentalization in Healthcare.

There are indeed many consultative bodies, collaborative structures, roundtables, platforms, pilot projects, associations, etc., …—all places where efforts are made to focus on “our patient” rather than “my patient.” Driven by legislation and funding, stakeholders come together to design better healthcare. However, putting these ideas into practice is difficult. After many discussions, we often return to our own silos without having achieved much.

What’s next? Where’s the BREAKTHROUGH? We can break through this dysfunctional aspect in the DNA of healthcare by letting go of silos. A healthcare crisis can only be averted if we truly start connecting and don’t stop until collaboration is complete. To achieve this, we must be transparent about data and financial flows. To achieve this, we must make data exchange easy (fortunately, policymakers are close to reaching a decision). To achieve this, we need a unified approach for “our” patient, placing them at the center of the entire healthcare chain. We must take that healthcare chain seriously, from prevention to palliative care. To achieve this, we need to use new technology and digitalization to enable more self-care and to handle simple care and monitoring tasks. But above all, to do this, we need administrators and medical professionals who are willing to let go of some things.

Paradoxically, we have to let go of the patient! Or, more precisely, let go of the box we put “our” patient in. We take responsibility for the patient together. Trusting one another—that helps.

The region is exactly the right starting point for this collaboration. National coordination is too broad, and at the local level, we cannot achieve the scale needed to deliver high-quality, efficient healthcare across the board. Chain integration in the region. Bring all parties to the table—with no turning back. Be willing to make sacrifices for the greater good. We can only embrace the new healthcare system if we let go of the old one. So, in the healthcare chain, let go of the patient—for the benefits of all patients.