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Dr. Pat Basu: “Get rid of the incentives to confuse patients”

I’m a huge believer in whole person care and the interconnectedness between medical determinants, behavioral, and social determinants of health. What we know at the individual level with certainty, is that physical health affects emotional health and emotional health affects physical health. This is also true at the system level and needs to be incorporated […]

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I’m a huge believer in whole person care and the interconnectedness between medical determinants, behavioral, and social determinants of health. What we know at the individual level with certainty, is that physical health affects emotional health and emotional health affects physical health. This is also true at the system level and needs to be incorporated into policy and population health.


As a part of my interview series with leaders in healthcare, I had the pleasure to interview Pat A. Basu.

Pat A. Basu, MD, MBA, is President and Chief Executive Officer of Cancer Treatment Centers of America (CTCA). A former Stanford Physician and White House Advisor to President Obama, Dr. Basu is a business leader and entrepreneur who has served as a senior executive in the corporate, government, private equity and clinical sectors. Before joining CTCA, he served as Senior Vice President and on the Executive Leadership Team of United Health Group/Optum and as a telehealth pioneer, Dr. Basu helped start Doctor On Demand, the nation’s largest provider of video visits and a telehealth benefit for over 30 million Americans.


Thank you so much for doing this with us Dr. Basu! Can you tell us a story about what brought you to this specific career path?

I was an engineer in undergrad but always loved medicine — helping care for people is so fulfilling and the science was always interesting. When I first started out, even as a medical student, I saw amazing people trying to solve life-threatening issues, but I also saw a broken system. It was then that I dedicated my career to building a better American healthcare system. All of my experiences from serving at the White House to co-founding one of the largest telehealth companies (Doctor On Demand), to leading the largest value-based care organizations (Optum) to helping fight cancer on a national level at Cancer Treatment Centers of America have all been tied together by my personal mission to help improve care for millions of Americans.

Can you share the most interesting story that happened to you since you began leading your company?

At each of our five Cancer Treatment Centers of America (CTCA) hospitals, we celebrate our five year cancer patient as “celebrants” during a formal celebration each year. I’m used to seeing patients whose stories revolve around their own survival, which is of course an incredibly moving and emotional experience. However, I at one of our celebrations, I met a woman and her two year old child. Her prior care institution told her initially that her therapy would not allow her to have children and then eventually that she would not survive. However, not only did she survive but she had a beautiful daughter. It was a powerful reminder of what is at stake and the mission of CTCA.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

When I was interviewing for one of my 40+ White House interviews and I showed up the day before the interview! I guess it was a good reminder that it’s better to be early than late!

What do you think makes your company stand out? Can you share a story?

What makes CTCA stand out is the ultimate focus on the patient’s satisfaction and needs. I’ve seen so many organizations that work around my schedule as a physician, or treat me better as a CEO, but at CTCA everyone is constantly thinking of the patient. I spoke to a patient who told me that one of our doctors took time to walk them all the way down to the lab when they asked how to get there and that custodial staff cleaning her room would ask her everyday how she was doing and they would talk for 15–20 minutes even knowing how busy she was. It touched me to know how much each employee at CTCA cares.

What advice would you give to other healthcare leaders to help their team to thrive?

Focus on the “why” in addition to the “what” and the “how”. Even great teams with great talent need to know what and why they are fighting for to obtain true performance.

Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

Sure, our system doesn’t behave like a system. There is so much variability everywhere in cost, quality, and the way patients are treated. We spend nearly 19% of GDP or more than 3 Trillion dollars but we have far too many mistakes in our system. For example, medical errors rank among the top five causes of death and lead to more than 100,000 deaths every year. One reason is poor alignment of incentives at every corner. Most parts of the healthcare system are not rewarded by better patient satisfaction, better patient quality, or less patient errors.

You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

If I could improve 5 things about the US healthcare system, I would change:

  1. Value Based care: Rewarding providers for the quality, satisfaction, and service that patients receive.
  2. Better aligned incentives: Right now, many providers get paid more if there is a medical error, many insurance firms actually make more when some drugs cost more or an employer’s costs rises and many great pharma companies don’t get rewarded to compete, they get rewarded to not compete or make a trivial change to their patent.
  3. Better use of technology: The actual technology available to healthcare is as good as most sectors, however it isn’t being deployed efficiently or used effectively. This is not because it doesn’t work but because either some special interest pushes back on the technology, the behavior change required takes a long time or because of a regulation that gets in the way.
  4. Get rid of the incentives to confuse patients: Right now, too many companies thrive by not having patients understand their bill, their rights, or even the options available to them. Patients need to be put at the center and have care, treatment, and billing be presented to them in clear, simple, and concise terms.
  5. State Barriers: Healthcare affects all Americans but too many regulations differ from one state to the next. Whether it is licensure, telehealth, or the inability to sell insurance, this failing helps contribute to the waste, poor competition, and lack of efficiency that plagues our health system.

Ok, its very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

Yes, healthcare suffers from a lot of status quo inertia. Patients/Consumers need to expect more and demand more. Would they wait 90 minutes for a restaurant, a bank, or anything else to have an 8-minute appointment followed by an indecipherable bill that arrives 6 weeks later for 5x the cost? No. Even though health is the most important thing and even though its complex, that shouldn’t be an excuse for bad service.

Corporations in many ways are doing what they can to respond to the current system and its incentives.

I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?

I’m a huge believer in whole person care and the interconnectedness between medical determinants, behavioral, and social determinants of health. What we know at the individual level with certainty, is that physical health affects emotional health and emotional health affects physical health. This is also true at the system level and needs to be incorporated into policy and population health.

How would you define an “excellent healthcare provider”?

I would define an “excellent healthcare provide” as a provider who puts the patient’s health above all other considerations and that their quality and service outcomes back this up.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“The greatest danger for most of us is not that our aim is too high and we miss it, but that it is too low and we reach it” ~ Michelangelo.

I have always believed in setting a high vision and pursuing it with great focus.

Are you working on any exciting new projects now? How do you think that will help people?

Yes, we’re doing some amazing things around both value based cancer care and using big data to unlock better, safer, and more effective cancer treatments and therapeutics.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

I think everyone should read Elizabeth Rosenthal’s an American Sickness. I also think Steven Brill’s America’s Bitter Pill is an important read.

I also really enjoy the podcast Freakonomics because it explores human behavior and decision making, which is so critical to being a healthcare leader.

How can our readers follow you online?

Twitter: @patbasu — https://twitter.com/patbasu

Linkedin: https://www.linkedin.com/in/pat-basu-md-mba-b34a53/

Cancer Treatment Centers of America:

Twitter: @cancercenter — https://twitter.com/cancercenter

Instagram: @cancercenter — https://www.instagram.com/cancercenter/

Facebook: https://www.facebook.com/cancercenter

YouTube: https://www.youtube.com/user/1cancercenter

Thank you so much for these insights! This was so inspiring!

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