Looking ahead - Leland Kaiser on the medical management profession

Physician Executive, Jan-Feb, 1990 by Wesley Curry

Looking Ahead

A difficult decade has come to an end, and not a minute too soon. Providers and buyers alike have been under great stress for the past 10 years. The byword has been change, as the health care field has been transformed. In the endless, some would say mindless, pursuit of cost containment, all manner of experiments have been attempted. Some have had the desired effect, if only in the short term. Most, having failed, quickly became a part of history. Health care costs continue to rise in spite of all the attention paid to them. Now the '90s. beckon. What new machinations will this final decade of the millennium bring, and how can the health care field position itself to deal with the additional changes that are certain to come? Last November, we talked to Leland Kaiser, PhD, noted health care futurist and President of Kaiser and Associates, Brighton, Colo., about his views on what health care has undergone and what the future holds for the system and for medical managers. This report highlights his views on the prognosis for the health care delivery system and its managers.

The Decade of Renewed Social Consciousness. That is how Leland Kaiser, PhD, sees the remaining years of the 20th Century. "We are going to be concerning ourselves with the problems of air, water, and earth," he says. "Problems of poverty, homelessness, the uninsured. Health care organizations are going to become very involved in community work. We will see the first bridge between public health and private health. We are going to see more money, time, and attention going into the early years of life, which set a major bridge between health care organizations and schools and between health care organizations and the family." The role of the future physician, Dr. Kaiser says, will be to prevent morbidity, establish good habits, and retrain people who have bad habits. What will be realized in the decade ahead, he says, is that what we need to do to improve health care is not now in the system. Only about 10 percent of the morbidity of the population is traceable to doctors, hospitals,