Anchors Aweigh!

By Clive Riddle, May2, 2013

In MCOL’s current issue of ThoughtLeaders, the question was asked “Which provision of the Affordable Care Act do you feel has had the greatest degree of success thus far with regard to implementation and achieving its objectives?”

The sage, and always insightful Peter Kongstvedt, MD, provided a response with an intro that demands repeating in part here, because it is that good:

Peter opens his reply with: “The answer to this or any other question must always be preceded with a question: Who’s asking? In other words, how successful or effective something is depends on who is defining success or effectiveness. The following table illustrates this:”

Person	Thing	Effectiveness
Drunk Don, drowning after diving into a pool	Inflated inner tube	Life-saving, thank God
	Gallon of water	No thanks, I take mine neat
	200 pound anchor	Is this a case of Murder?
Desert Pete, far from civilization without his mule or canteen	Inflated inner tube	In the desert? Useless
	Gallon of water	Life-saving, thank God
	200 pound anchor	In the desert? Worse than useless
Yachtsman Biff on his unmoored sloop, foundering off the lee shore of a rocky isle	Inflated inner tube	May need it if can’t anchor yacht
	Gallon of water	May need if need to abandon ship
	200 pound anchor	Life-saving, thank God

The wisdom of Peter’s anchor analogy is not only humorous, it is quite profound.  We all need to keep Drunk Don, Desert Pete and Yachtsman Biff in mind as we tackle the spectrum of healthcare issues stretching out from here to the horizon, with the understanding that whether we’re talking about reform policy issues, readmissions management, health plan marketing segmentation, performance analytics, wellness incentives, and on and on…. the needs, solutions, outcomes and metrics are not one size fits all. Populations, geography, situational scenarios..they all matter.

Peter expanded on his ThoughtLeaders response in his own blog, which is highly recommended reading. I urge you to click now and check out the KvedtBlog from PR Kongstvedt Company!