Health Care (and my Knee)

My apologies to MTD followers and to those who have written regarding opportunities at JFP Holdings as a result of the recent New York Times article.  I left China on August 12 and have spent most of my time since at Shadyside Memorial Hospital, one of the many fine hospitals that comprise the University of Pittsburgh Memorial Center hospital system.

My purpose for spending time at UPMC Shadyside was not to research new technology that China might adopt as part of its efforts to upgrade its medical system — although I did see a great deal of technology and management best practices that certainly would have application. Nor was it to get a first hand look at the American health care system so that I might be better informed regarding the health care debate that is currently raging in the United States — although I must admit that I came away from my experience as an even more ardent supporter of the many talented doctors, nurses and administrators that are the heart of the health care system in the United States.

My reason for spending almost a week at UPMC was much more personal. Almost 40 years ago, a downfield block on a kickoff return in Yale’s annual match against Columbia left me with a severely damaged left knee. After years of living with the aftermath of this injury, it was finally time for me to trade in my old knee for a newer model.

I chose to have the surgery done in Pittsburgh at a UPMC hospital, partly because I am from the Steel City and have a great deal of loyalty to it, but mostly because I have learned a great deal about UPMC over the past year and couldn’t imagine having such an important operation done anywhere else. Here are some excerpts from the UPMC Web site that illustrate what I mean:

UPMC is an integrated global health enterprise headquartered in Pittsburgh, Pennsylvania, and one of the leading nonprofit health systems in the United States. As western Pennsylvania’s largest employer, with 50,000 employees and $7 billion in revenue, UPMC is transforming the economy of the region into one based on medicine, research, and technology. By integrating 20 hospitals, 400 doctors’ offices and outpatient sites, long-term care facilities, and a major health insurance services division, UPMC is providing a seamless continuum of care. In collaboration with its academic partner, the University of Pittsburgh Schools of the Health Sciences, UPMC has advanced the quality and efficiency of health care and developed internationally renowned programs in transplantation, cancer, neurosurgery, psychiatry, orthopedics, and sports medicine, among others.

UPMC is commercializing its medical and technological expertise by nurturing new companies, developing strategic business relationships with some of the world’s leading corporations, and expanding clinical services and state-of-the art medical expertise into international markets, including Italy, Ireland, the United Kingdom, and Qatar. UPMC has invested significantly in information technology to link and integrate electronic medical records across multiple hospitals and care settings and has invested in research to seed new fields like regenerative medicine and bio-security.

Based on my experience, I can attest to the fact that UPMC more than lives up to its billing. The surgery, and the all important post-operation recovery period, have gone extremely well. Privacy dictates that I not disclose the name of my surgeon, but he is one of the best in the field and I would be happy to provide a referral privately. Moreover, he was supported by an extremely capable team of specialists and nurses.

This was my first overnight stay in a hospital, and I learned a great deal from it. Putting on my operations hat, I was particularly impressed by three aspects of UPMC’s program: teamwork, the pain management program and the high level of technology employed.

As they wheeled me out of the operating room and into recovery, I was struck by the number of different specialists who had been involved in getting me a new knee. The seamless way in which they worked together and the teamwork they exhibited would have made any CEO or football coach proud. It stood in sharp contrast to the many situations I have encountered in my professional life where egos and bureaucracy often cause professionals to work at cross purposes.

Before the operation, and every day while I was in the hospital, I was visited by the “Pain Management Team,” which consisted of medical professionals with specialties in all types of anesthesiology and pain management techniques. Their job was to ensure that I was receiving whatever pain relief was required to speed up the healing and recovery process. The first question that every nurse, doctor and therapist asked me was to quantify my pain level on a scale of 1 to 10, with 10 being the worst that I had ever experienced and 5 being the level at which I would ask for relief. Their objective was to keep me below 4 at all times.

From the cobalt chromium prosthetic that forms the base of my new knee, to the nerve blocks that were used to localize pain management and minimize the use of pain killers, to the infrared cameras and sensors that my surgeon employed to ensure that my new knee is absolutely, perfectly straight, I was very impressed by the wide range of technologies that are now used in modern medicine. I’m certain that many of these are already available in China, but I’m also certain that many aren’t. I came away from my experience more convinced than ever that the health care area generally is one of the biggest opportunities going forward in China.

The debate rages in the United States about the U.S, health care system. Everyone agrees that costs are high and that there are many issues with respect to insurance — portability, insuring the un-insured and un-insurability due to pre-existing conditions — that must be addressed. The differences lie in how to fix the system. President Obama and the liberal Democrats want the government to play a greater role, and everyone else wants the government out of it.

Based on my experience, I can draw two conclusions. First, I disagree vehemently with anyone that ranks the U.S. health care system as anything but #1 in the world. I wouldn’t think of having the operation I had anywhere else, and I doubt that even the system’s harshest critics would come to a different conclusion. Secondly, true tort reform and allowing the 1300 health insurance companies in the United States to compete across state lines would address most of the cost and competition issues that President Obama and his followers are trying to solve with an expensive government run system.

2 Responses to “Health Care (and my Knee)”

  1. Hi Jack,

    Given how much time you’ve spent in China, I’m curious | besides aspects of medical continuity | why you wouldn’t have had this done in the PRC? That flight back Stateside alone must have caused you an untold amount of needless pain, no?


  2. Jack,I would assume the flights back and forth from China to the U.S. are frequent and routine. In addition, the pain associated with deteriorating joints, is more gradual and you learn to live with it, so to speak. I think it is great that you had the operation and now it is time to rehab and be patient. I know a number of individuals who have had their knees replaced, and the consensus is “What took me so long?” I imagine you were just busy. I do not imagine that you receive to much advice and I am not a doctor but get on your bicycle could be simple words of wisdom, the cycling motion, builds strength and in turn stability. Your blog is fanastic keep up the amazing insight.