New Marketplace
Clip
The Music of Medicine: Orchestrating Better Care (02:56)

When cardiologist Eugene Braunwald, who loved classical music, visited the Mayo Clinic, he said, “We have a fantastic string quartet. They have an orchestra.”

“He was giving the message that we might feel jealous and we might have something to learn from that. How would that comment go over with your respective organizations?” asks Tom Lee.

Emme Deland, Senior Vice President and Chief Strategy Officer at NewYork-Presbyterian Hospital, responded in concert. “We actually hired an orchestra to come and play for us in front of all of our senior leadership to listen to how they work together to play — there were 90 of them — to see what they did to make sure they were in concert and coordinated as a demonstration of the kind of work that we need to do,” she says. In the words, “we are napkins, searching to be a tablecloth,” Deland adds that her team recognizes the need to be more coordinated, and that they’re taking steps to get there.

“We have an accountable care organization that we started, and we are part-owners with our two schools. I think it’s a significant step forward to the recognition that we need to work together and we need to be more of an orchestra than a string quartet,” Deland says.

Jeff Balser, President and CEO at Vanderbilt Medical Center, agrees, and makes an important point — that the Mayo Clinic functions so well like an orchestra because it’s been practicing for a long time.

“Great orchestras don’t just form and sound wonderful in a half a year. They practice for years and years before they really sound good,” says Balser. He adds that academic medical centers “now have religion about this” and are starting to work toward functioning more like an orchestra. But, he adds, the country needs to have a little bit of patience.

“We’re moving large aircraft carriers in a very much different direction than they’ve functioned for probably for 150 years, and that will take time,” Balser says. “We will get better and better at this. And I think we’re inexorably moving in the right direction.”

From the NEJM Catalyst event New Risk, New Business Models held in Boston, October 6, 2016.

More From New Marketplace
Arkansas Blue Cross and Blue Shield Value-Based Compensation Model

Changing Health Care Compensation by Rewarding Value-Based Outcomes

Fee-for-service compensation is unsustainable, but what is the solution? Arkansas Blue Cross and Blue Shield’s proactive new payment model reduces payment for low-value care and uses the savings to reward high-value care.

Reframing the Conversation on Drug Pricing

We can’t afford for current trends to continue. There is only one solution.

Health Insurance Price Discounts: 2014 median hospital billed charges and median allowed (negotiated) insurance payments by admission type

The Value of Health Insurance through Price Discounts

How health insurance secures lower prices for health care services, leaving uninsured individuals facing medical debt and difficult choices.

ED Telehealth Express Care Service Patient Room

Revolutionizing the Delivery of Care for ED Patients

How the NYP OnDemand Emergency Department Telehealth Express Care Service reduced stay times and revisit rates in one year.

Targeting Unconscionable Prescription-Drug Prices — Maryland’s Anti–Price-Gouging Law

Why, in the early 21st century, are so many drugs that were cheaply available in the 20th century becoming prohibitively expensive?

The Economics of Indication-Based Drug Pricing

What would indication-based drug pricing accomplish?

Navigating Pharmaceutical Price Increases: A Strategy to Protect Appropriate Use, Reduce Waste, and Identify Therapeutic Alternatives

In the face of major pharmaceutical price increases, Cleveland Clinic developed a strategy to ensure high-quality patient care while maintaining financial stability.

Controlling the Cost of Medicaid

Both political parties should support policies that focus on incentives as a mechanism for improving and sustaining their value.

Resetting the Nation’s Health Care Quality Agenda

Poor measures of care quality have consequences. The National Quality Forum is essential to creating measures that are valid and reliable.

Opportunities for Private-Sector Entrepreneurship in Health Care Transformation

Two veterans of public service say that government can do only so much — which creates attractive business opportunities for entrepreneurs.

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

What’s Your Competitive Differentiator?

If you’re doing the same thing as everyone else, the same way, you’re ultimately competing…

Value Based Care

122 Articles

New Marketplace Survey: What’s Next for…

As health care reform struggles to gain traction legislatively, health care professionals report that payment…

New Marketplace Survey: What’s Next for…

As health care reform struggles to gain traction legislatively, health care professionals report that payment…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now