New Surgery & Perioperative Care Chair: We Have to Teach Something Different

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“When you’re through learning, you’re through.” -John Wooden, legendary college basketball coach

Dr. Kevin Bozic has learned a lot. One thing he’s learned is that he’d rather be operated on in a hospital willing to tell the world it has a post-surgical infection rate that’s worse than the national benchmark, like the one he found featured in a brochure bar chart revealing just that.

“I’d go there because they’re measuring outcomes that are important to patients, and that they are committed to improving – and they’re not afraid to admit that,” said Bozic, inaugural chair of the Dell Medical School at The University of Texas at Austin’s Department of Surgery and Perioperative Care.

“This is the culture we want to develop here in Austin,” Bozic told Seton leaders during a the May 27 meeting at Seton Healthcare Family. “Not one that says we’re better than everyone else in everything that we do, but that we are measuring the right things and we want to do everything we can to improve.”

A professor of orthopedic surgery who also earned an MBA at Harvard Business School, Bozic called on all local physicians to seize the opportunities provided by the new medical school and the future Dell Seton Medical Center at The University of Texas and three sister medical training facilities: Seton Medical Center Austin, Seton Shoal Creek Hospital and Dell Children’s Medical Center of Central Texas.

“I tell my students these are the glory days of medicine,” he said. “Not since 1966 have we had the chance to completely redefine how we deliver and pay for health care. It’s been 40 years since a tier one research institution has built a brand new medical school. And that’s why I’m here.”

Bozic also discussed:

  • Dysfunction. Too many healthcare providers today are too focused on fixing problems, not preventing them. There are too many unnecessary medical tests, added costs, “defensive medicine” and an unaffordable “medical arms race” involving hospitals and physicians. But the primary driver of dysfunction in the U.S. healthcare system is a lack of competition based on value, he said.
  • Measurement. Bozic noted, ““We have to measure things that, ultimately, matter to the patient, not what looks good regarding … what we, the provider community, think matters.”
  • New medical technology that isn’t beneficial. A specialist in complex, minimally invasive hip and knee replacement, Bozic noted the most popular artificial knee used in U.S. replacement surgeries costs about 20 percent more than a standard replacement knee because it functions better in patients who can bend their knee past 130 degrees; however, only 3 percent of knee replacement patients can bend their knees that far.
  • Peer review before approving new technology purchases. Physicians dislike “bureaucratic sounding committees” making these decisions. Bozic recommends bringing physicians to the table in negotiations with vendors and using objective, evidence-based metrics to determine if purchases should occur. Recalling his experiences at The University of California at San Francisco School of Medicine, he said, “We got rid of non-value-added technologies completely. This is cost-avoidance. I had physicians tell me… this is the way new technology should be evaluated.”
  • Value – as defined by patient outcomes achieved vs. dollars spent to achieve them. He said, “Everybody wins if we can improve value – most importantly, our patients.”
  • Strong leadership, especially among physicians, to work with health care executives to reorganize patient care, eliminate silos – organizational and financial – and form integrated practice units that fully address each patient’s needs.

“What we ultimately want to create in Austin is a learning health system,” Bozic said. “We want to continuously measure and improve our care delivery systems. We have to teach (medical students and residents) something that is different from what the rest of the country has.

“We’re going to teach them health system improvement, engage them in meaningful work and evaluate and study what we’re doing,” he said

It’s all in pursuit of “a singular mission of improving health and health care.”

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