I know I run the risk of being shot by friends and colleagues for even suggesting something like a ‘moneyback guarantee’ in medicine. I am aware of all the usual arguments about why it cannot be done and why my understanding of issues in medicine is so limited. Let me begin by capturing some of these arguements.
Medicine is a profession, which involves huge risks. Our understanding of how the body works and heals is limited. All the advances in medicine that we have witnessed in the past decades, while incredible do not still allow us to say with certainty that what works for John will also work for Joe assuming they have similar problems and are being treated by the same doctor. Each individual is different, and he responds to medicine in a different way. Moreover, medicine is an inexact science, the outcomes are dependent on too many factors beyond the control of the doctor and that it is next to impossible to predict a successful outcome.
I agree with all this, except the fact that outcomes cannot be predicted with any degree of success. They can be. Cardiac Surgeons blithely talk about a success rate of more than 98% for something as delicate as bypass surgery and surgeries involving the prostate, gall bladder and hernias have a close to 100% success rate. I also know of Orthopaedic and Spine Surgeons, who pride themselves in success rates of over 98%. These are facts that can easily be ascertained and documented.
If we know that the mortality or complications rate for a particular surgery in a particular hospital is in excess of say 98% than I see no reason why a moneyback guarantee can not be issued. The hospital stands to loose the fee earned in just 2% of the cases averaged out over a period of let us say a year. Financially this makes complete sense.
Surgeons and clinicians regularly communicate these risk factors to individual patients. My mother needed a bypass surgery last year. The surgeon we went to had a more than 98% success rate with this kind of surgery and he told us so. That really helped my mother, who was extremely worried about being under the knife. Now why can’t this be communicated to a wider audience and also put some money where one’s mouth is?
Let us also consider what the promise of a moneyback guarantee tells me – the customer. First and foremost it establishes the point that the hospital has complete faith in the abilities of its surgeons and doctors, it is willing to wager its money on a successful outcome. The moneyback guarantee also tells a patient that the hospital is absolutely confident of its systems and processes, nursing care and infection control protocols. Above all it makes the point that the hospital is willing partner in sharing my risk at least to a certain extent.
Imagine, what a powerful tool a promise like this can be in the hands of skilled marketers. The promise smacks of supreme confidence and provides a powerful reassurance to patients. It makes the hospital standout from everyone else as unique. It inspires trust amongst customers. It sounds honest and makes the hospital look like a partner in the process of care for the patients.
I do believe that the time for limited money back guarantees in healthcare has arrived. All it requires is a bit of courage from a surgeon and a hospital to stand up and go for it.
The image is courtesy http://www.flickr.com