The Bottom Line: A Physician’s View of Health Care Bill Petersen, M.D. April 15, 2004 As patients, we are consumers of a service – mental and physical health care – that is deeply disorganized. Primary stakeholders in this field – providers, lawyers, insurance companies, businesses, government and patients – have brought separate standards to the table in regard to cost, quality and ethical treatment. And for professionals who were once drawn to the field to help others, there is growing dissatisfaction.Twelve years ago the first MBA in Medical Group Management (MGM) program at St. Thomas brought a diverse cohort of professionals together to learn about managing health care. In the first class, three prominent guest speakers were asked to share their experiences. Their diverse viewpoints typify the paradox facing health care then and now. The first speaker was Richard Burke, who had just made millions of dollars from his sale of Physicians Health Plan stock. Burke was clear that his goal was based on minimizing costs and increasing profits. It was a rude awakening for the cohort. The next speaker was Bill George, chairman and CEO of Medtronic. George discussed the importance of balancing business needs and profits. For a successful company, it is important to maintain the correct mix of business acumen while offering products that help patients live longer and fuller lives. Last to speak was Dr. James Shannon, a former president of St. Thomas. Shannon stressed the importance of practicing a values-based, compassionate approach to patient care.In a single day, the cohort had heard a wide spectrum of health care perspectives. Students were asked to balance this paradox in their own professional lives, a balance that continues to be asked of students today.In the last 50 years I’ve been a witness to and full-time participant in the evolution of health care in Minnesota. We can be grateful for the many men and women who continue to anticipate and plan for changes in our field. And with the Center for Health and Medical Affairs, MBA in MGM, Leadership College and National Institute of Health Policy, St. Thomas should be recognized for its role in this process.Students of these programs are asked to step away from the obstacles of the past and anticipate new ways to deliver health care. After all, health care grew from a cottage industry of artisans – doctors and nurses that had established unique and personal ways of offering care.Now, of course, there are larger and larger health care delivery systems that struggle to be more effective and more efficient. The cost of caring for patients has increased, while revenue remains flat. At the same time, there is uneven quality in the care provided by doctors who, as a profession, are increasingly less proud of what they do. The result is a lack of forward-looking and visionary doctors who have the time and ability to develop the next model for health care.I can only speak from a physician’s point of view. Many others voice their own views and advocacies. But solutions to the paradox noted above will only come though constructive dialogue and compromise. St. Thomas, by offering educational programs that reach across most stakeholder groups, has the opportunity to serve as a neutral forum for the cooperation needed to improve patient care at the same or lower cost. My profession is very different than it was 20 to 30 years ago. But doctors still love medicine, and they still genuinely care for their patients. We all want to deliver the best care possible.Bill Petersen, M.D., graduated from the University of Minnesota Medical School in 1945 and served as a full-time faculty member in internal medicine until he entered private practice in 1952. In 1984 he became vice president of Medical Affairs at Abbott Northwestern. He later served as senior medical officer at Allina before retiring in July 1994. Petersen is the founding director of the Center for Cross Cultural Health, and was the former program director for the St. Thomas Center for Health and Medical Affairs.