Virtual AORN Expo Closing Session: Preparing for the Future of Health Care

For years, Dr. Marty Makary, MD, MPH, FACS has been advocating a “redesign of healthcare” to think differently about ways to improve the quality and cost of care and do what’s best for the patient – even if it reduces the bottom line.  The disruption caused by the pandemic is making those changes more imperative than ever.

“COVID is testing our healthcare system to see if it’s resilient, whether or not it can respond in terms of staffing, research, and understanding a new illness.”

Makary’s assessment is that the response from a national level in terms of research did not provide answers to immediate questions, such as: How does COVID-19 spread? Do masks work? When are you most contagious? How long are you contagious after contracting the illness?

Rather, he says, of the $42 billion the NIH spent in 2020, less than 2 percent was spent on COVID clinical research: four grants went to study transmission, two grants on masks, and no grants specific to children.

“What filled that vacuum were opinions. It wasn’t informed by people on the frontlines of care – nurses and doctors. We need to be more connected to those who interact with patients as a healthcare system.”

And listening to patients, who consider themselves today as health consumers, is also important, he adds. They are concerned about whether they really need a medicine, an operation, or a diagnostic test. They want to know the alternatives and the cost of doing something. And Makary calls those the right questions, ones that health professionals should think about because “people are hungry for an honest dialogue.”

Addressing the underlying issues that bring people to care, not just the care itself, is also key. He says the reason why the U.S. had a high fatality rate from COVID-19 is because “we have one of the most comorbid populations. A CDC report this year showed that 78 percent of those hospitalized were overweight or obese.”

In his presentation, Makary also notes the importance of civility in the perioperative setting: communicating clearly and expressing concerns in a non-confrontational way is “the fabric” of great patient care.

“We spend a tremendous amount of time talking about technical skills in the OR and the instrumentation,” he says. “But non-technical skills can have a better impact on patient care.”

If you couldn’t catch Makary’s session, the recording is now available in the on-demand library through Sept. 24.