Professor Kekomäki would concentrate surgery to hospitals that already perform many of them
If surgical operations were concentrated in larger units, we could perform more of them with better efficiency and safety, although there are some exceptions. This is the view held by Professor Martti Kekomäki, who will receive the Pohjola and Suomi Mutual Medical Award for his long-term and successful work in health care management and promoter of health economics principles. The committee that chose the winner consisted of chairmen of the boards of the Finnish Medical Association, Finnish Medical Society Duodecim, Finska Läkaresällskapet and the Finnish Medical Foundation.
Professor Kekomäki is an internationally renowned trainer and expert in the fields of health economics, methods and management. He has been Administrative Chief Physician at the Hospital District of Helsinki and Uusimaa (HUS) and Professor of health and nursing administration at the University of Helsinki. He is a surgical and paediatric surgical specialist by training. He has been training health care professionals as managers for a quarter of a century. He also worked for a long time as a clinical consultant for the health care methods assessment unit of the Finnish Office for Health Technology Assessment and is still active in both Finnish and international duties.
- "It is quite a different matter whether you perform 5 or 50 operations of a certain type in a hospital per year," he says to explain the power of concentrated surgeries. Surgeons who perform the same operation many times get better as they get more experienced. The fewer operations you perform, the greater the risks and the more likely errors will take place. Practice makes perfect in this field, too.
Finnish hospitals where such a model has been developed systematically have achieved very high productivity levels. He takes a relatively small HUS hospital in Porvoo as an example where it is now standard procedure to make anaesthesia preparations outside the operating theatre, and to discharge patients as soon as possible. Once patients have been discharged, they became active in their own rehabilitation and more motivated to make a quick recovery. It is Kekomäki's experience that if patients, especially older patients, stay in bed, they lose muscle mass at a rate of several per cent per day, which may even jeopardise what was achieved with the operation.
His view is that comparative analyses of health care should be carried out, because there are good a bad practices even within countries. When reforming health care, it is also useful to see what other Western countries have done, whether it concerns management, IT solutions or choice of treatment methods.
Financing is obviously closely related to the concentration of medical procedures. Kekomäki is in favour of public health care funding and a single-channel funding model that would cover practically all costs arising from illnesses and their treatment. This would not rule out people's option of buying health services from the private sector if they so choose. When building the system, the number of administrative layers should be as low as possible, and the principle of regional equality should not be compromised.
- "I am a totally apolitical person and I see the market economy operating well in a number of issues. But it does not at all suited to health care, because it is difficult to define both the product and the customer in publicly funded health care. Health care funds must not be controlled by the markets. Disputes over service agreements are already burdening our judicial system.
Treatment must be provided on the basis of patients' clinical needs - not by their income, place of residence, or education. Even in the USA, equal treatment of citizens is one of the yardsticks for measuring health care quality. Professor Kekomäki is concerned about a polarisation of our society, differences in various population groups' state of health and the exodus of GPs from health centres, which fortunately has slowed down somewhat in recent years.
- "We should not separate people like sheep and goats. Health care is the only area where we are responsible for our less fortunate brothers. Older people, too, should feel that they are full members of society. Health care brings together the entire spectrum of human life, from cradle to grave, from having money or not, from hope to despair. Maintaining hope is central to the healing process, as mere technology and treatment cannot solve everything," says Kekomäki.
All of us also have a responsibility to look after ourselves, too. People must be encouraged to make healthy choices every day in a positive way.
Management leads to better quality
All management is essentially change management, but Kekomäki emphasises that health care management is different from running a large company. Health care management is above all improvement of all care quality on a daily basis.
Awarded annually since 1981 at the Finnish Medical Convention, the Pohjola and Suomi Mutual Medical Award is recognition of a person's considerable life's work both domestically and internationally. Professor Martti Kekomäki will hold a speech titled "On the Brink of New Things" at the Finnish Medical Convention on 10 January 2013 as he receives the award. The award will be presented by Jouko Pölönen, Pohjola Insurance's President, and Jari Sokka, President and CEO of Suomi Mutual.
For more information, please contact:
Professor Martti Kekomäki, tel. +358 (50) 358 1448, martti.kekomaki @fimnet.fi
Anne Lamminpää, Chief Physician at Pohjola Insurance, tel. +358 10 253 2418, firstname.lastname@example.org
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