In this second take on episode host Stacey Richter speaks with Dr. Tom Lee, founder of One Medical and Galileo. The discussion centers on the survival of independent primary care practices in the current healthcare economy, the associated challenges, and the paradox of primary care.

Topics include reducing ER visits, managing downstream specialty spend, and the imbalance between CMS and commercial carrier payments to primary care practices.

Dr. Lee highlights the importance of 'enlightened leadership' and a 'value-focused mindset' in balancing efficient service operations with quality care. He also touches on the complexities of integrating technology and human-centered care, the importance of operational efficiency, and the challenges posed by current reimbursement models.

For a bonus sidebar conversation with Dr. Lee, click here.

=== LINKS ===
🔗 Show Notes with all mentioned links:
https://cc-lnk.com/TakeTwo-EP445

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=== CONNECT WITH THE RHV TEAM ===
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✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social
✭ X https://twitter.com/relentleshealth10:30 What is the paradox of primary care?

12:47 Why is it hard to run an independent primary care practice?

13:29 What are the barriers to running an independent primary care practice?

14:09 Can you have fee for service and value?

15:53 “Value is more about a mindset.”

16:49 What hidden waste is there in a primary care practice?

18:36 What do you need to have a value-focused mindset?

20:41 Why does access precede quality?

22:40 What are the nuances of a service business that make them challenging for managers?

23:27 How do you find the balance between fee for service and value?

30:07 EP438 with John Lee, MD.

31:04 How can you invest in quality without a value-based contract?

33:09 How do you address the trade-off between fee-for-service finances and investing in value-based care?

34:26 Where is the “productive middle”?

35:18 Dr. Tom Lee’s message to payers.

38:45 Dr. Tom Lee’s message for policymakers.

Balancing Mission and Margin in Healthcare: A Candid Conversation with Dr. Ben Schwartz

In this episode, host Stacey Richter engages in a deep dive with Dr. Ben Schwartz to explore the phrase 'No Margin, No Mission' and its practical implications in the healthcare industry.

They discuss the complex relationship between profitability and mission-driven care, the challenges of value-based care, and the role of dyad leadership. The episode emphasizes the importance of transparency, regulatory measures, and trust in fostering a balance between mission and margin. Along the way, Dr. Schwartz shares insights from his new role at Commons Clinic and addresses broader systemic issues like regulatory capture and the subjective nature of defining value in healthcare.

=== LINKS ===
🔗 Show Notes with all mentioned links:
https://relentlesshealthvalue.com/episodes

✉️ Enjoy this podcast? Subscribe to the free weekly newsletter:
https://relentlesshealthvalue.com/join-the-relentless-tribe

🫙 Support the podcast with a small donation to the Tip Jar:
https://relentlesshealthvalue.com/join-the-relentless-tribe

🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1

🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b

📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue

=== CONNECT WITH THE RHV TEAM ===
✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/
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✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social
✭ X https://twitter.com/relentleshealth/

08:50 Sister Irene Kraus and the origin of no margin, no mission.

10:01 Margin and mission versus profit and profiteering.

12:45 Stacey’s manifesto (EP400).

13:01 What is the broad mission within healthcare?

14:12 What is mission drift within healthcare?

15:54 EP474 with Yashaswini Singh, PhD.

17:26 Why do we struggle with balancing margin and mission?

20:47 EP455 with Beau Raymond, MD.

20:52 How does value vary?

23:18 EP326 with Rishi Wadhera, MD, MPP.

23:53 What needs to happen to balance margin with mission?

28:29 Why does everything come down to trust?

28:33 EP391 with Scott Conard, MD.

30:30 EP419 with Andreas Mang.

32:21 What are the “vectors of change” to create balance between mission and margin?

32:43 EP475 with Peter Hayes.