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Balancing Healthcare’s Double Bottom Line

I recently took a loved one to see a highly renowned physician at one of the top health systems in the country. The doc was amazing, and he dedicated an incredible amount of time explaining to us the highly complex case. After multiple visits across multiple weeks, we got a recommendation, but it came with a strange disclaimer:

“Just so you know we are a not for profit hospital so please don’t think we are doing this for the money. I get paid the same.”

I loved the doc, and while I understood what he was trying to communicate, I was a bit taken back by his comment. As long as you get your pay you don’t care how the hospital does financially?

Unfortunately, this is not a rare occurrence. Most people I interact with in the healthcare industry, including clinicians, have not connected good business with good clinical outcomes. Many of them struggle to balance what I call healthcare’s “Double Bottom Line.”

It’s not just a matter of “you should have both;” it’s “you must have both.”

What is the Double Bottom Line?

The first bottom line comes from the brilliant clinical outcomes and innovations found in healthcare. Lives have been restored, pain diminished, and limbs reattached by incredible innovations like 3D printed organs, lab-grown skin, transplants, robotic surgery, and amazing prosthetics; the awe-inspiring list could go on forever!

All of these make up healthcare’s clinical bottom line.

But the other line is much less glamorous and far more controversial: the business bottom line.

Many people blame “those dang suits” and their focus on this bottom line for hurting healthcare, and as someone who has spent the majority of my career amongst those suits, I understand why they may think that. But not all the suits have terrible motives, and not every concern for better business practices is created equal.

The struggle is in balancing the “Double Bottom Line” because, in reality, clinical outcomes cannot be divorced from good business practice and healthy finances. Being on the “suits” side of healthcare, I have seen a direct connection between business efforts and positive impacts on patients served by the healthcare organizations. My greatest source of discouragement comes when healthcare professionals can’t seem to embrace solid business principles in order to improve results.

At the same time, business folks can’t seem to bridge the conversation to clinical outcomes and clinicians have no interest in the business stuff. How did this happen? How did such an important industry get so disconnected that what most industries implemented 30 years ago are innovative concepts in the business side of healthcare today?

Neither side has learned how to balance the double bottom line. It’s not just a matter of “you should have both;” it’s “you must have both.”

Having Both

Successful businesses are efficient, smart and know that to stay ahead one must always have an eye on all that is better, cheaper, and faster. Every aspect of the product lifecycle matters, and all parts are scrutinized for quality and cost. You can’t sell a great car if your logistics organization is terrible. You can’t build a great house if your accounting is bad. And you can’t provide excellent clinical outcomes if your operation costs get too high.

Healthcare professionals can get so focused on the clinical improvements that we tend to forget about all the other stuff in the “product” lifecycle. The clinical achievements are incredible and the people that do them are amazing, but giving some attention to the business bottom line can lead to innovative new ways to make healthcare more efficient.

Thinking about the business bottom line doesn’t mean putting more money in the suits’ pockets. It means finding more efficient and effective ways of operating within the healthcare industry.

For instance, right now it costs about six dollars in administrative fees to schedule a referral appointment. Finding ways to reduce this cost could allow provider staff to reallocate their resources to the patient. Mistakes tend to stack up with all the back and forth required to schedule the appointment, so reducing the number of phone calls or communication exchanges will also help minimize errors and decrease the time between the appointment. Thinking about the business bottom line doesn’t mean putting more money in the suits’ pockets. It means finding more efficient and effective ways of operating within the healthcare industry.

What if instead of only having the ability to schedule two or three patients per hour, a scheduler could schedule 30? Or if the patient could leave with an appointment in hand instead of leaving their physician’s office with the burden of identifying who and where to go next? What if the appointment only took two minutes to book and it sent the patient information directly to the receiving provider’s EMR?

These types of business innovations can help improve the business side of a health system by millions of dollars per year while simultaneously improving clinical outcomes. You get both! This is just one little example of innovations that benefit the business bottom line of healthcare, and all these what-ifs are actually achievable today. As I wrote about previously, the Distraction of Disruption limits quick adoption, but it doesn’t have to. Solutions like Blockit and others exist to bring a balance to the double bottom line and to empower health systems to have great clinical outcomes and outstanding business practices.

I’m thankful for the great clinical outcome my loved one experienced because of the physician’s focus on the clinical bottom line, but I want to see an end to the assumed divide between good business practices and good clinical outcomes. Healthcare doesn’t need to pit the two against each other. Instead, we can invest in ways of balancing the two bottom lines, ensuring that every good business decision leads to improved clinical outcomes.


Dave Gregorio is the Chief Customer Officer at Blockit and the author of the Purpose Quotient®, a nationally recognized framework for Organizational Development. A 30 year healthcare industry professional with a passion for people, Dave is the founder of the Heroes to Healthcare mission and CEO of ImPowerQ Associates LLC.


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