Larry Diamond of Mitesco: In light of the pandemic, here are the five things we need to do to improve the U.S. healthcare system

Improve individual accountability to health. Fifty percent of Americans lack the knowledge, skills, and confidence to be accountable for their health. Accountability means embracing healthier lifestyles, eating less and better foods, increasing activity, taking medicine and supplements as agreed to with the clinician, and educating themselves to make better choices in life overall. The first step is to meet people at their level and use validated tools like PAM to help people begin building the knowledge, skills, and confidence to improve the quality of their lives.

The COVID-19 Pandemic taught all of us many things. One of the sectors that the pandemic put a spotlight on was the healthcare industry. The pandemic showed the resilience of the US healthcare system, but it also pointed out some important areas in need of improvement.

In our interview series called “In Light Of The Pandemic, Here Are The 5 Things We Need To Do To Improve The US Healthcare System”, we are interviewing doctors, hospital administrators, nursing home administrators, and healthcare leaders who can share lessons they learned from the pandemic about how we need to improve the US Healthcare System.

As a part of this series, I had the pleasure to interview Larry Diamond.

Larry Diamond brings more than 25 years of executive leadership experience driving growth and profitability at public and private healthcare organizations, from large enterprises like UnitedHealth Group to early-stage companies like PointRight and InsigniaHealth. He has worked in population health, patient engagement, telehealth, analytics, government programs, pharmacy management, medical device, post-acute care, and healthcare technology. His operational roles have included general management, M&A, marketing, sales, operations, product development, customer service, and strategic planning. Larry earned his MBA in marketing and finance from the University of Minnesota’s Carlson School of Business, and his Bachelor of Science degree in business administration from the University of Richmond’s Robin’s School of Business.

Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you share the most interesting story that happened to you since you began your career?

While working at Merrill Lynch, I opened a 100,000 employee/ hundred-million-dollar annual funded employee stock option plan for one of the largest U.S. beverage companies … on a cold call.

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

Said with humor, “You are never a complete failure in life, you can always serve as a bad example.” For me, it means keep trying. You never really fail until you give up the fight.

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

We are starting up The Good Clinic. It is exciting because it has the potential to improve the lives of our clients by increasing convenience, reducing delays in care, and lowering costs. The clinics are located close to where people live, they offer in-person and video-based visits, and we take the time to understand each person’s needs and individualize the care to meet the person at their level.

How would you define an “excellent healthcare provider”?

An excellent healthcare provider takes the time to understand each person’s unique needs and adjusts the care intervention, education, and coaching to each person’s knowledge, skills, and confidence. The result is that each person becomes a partner and/or leader in their own care process.

Ok, thank you for that. Let’s now jump to the main focus of our interview. The COVID-19 pandemic has put intense pressure on the American healthcare system. Some healthcare systems were at a complete loss as to how to handle this crisis. Can you share with our readers a few examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these specific issues moving forward?

We have known for some time that there are inequities in U.S. healthcare system that negatively impact peoples’ health and their lives. According to the CDC, COVID-19 has inequitably affected racial and ethnic minority groups, putting them at increased risk of getting sick and dying from the virus. In 2020, the pandemic underscored the need to make significant investments in our public health systems, expand insurance coverage, and ensure that all U.S. citizens have access to healthcare. At the Good Clinic, we want to improve outcomes for people and increase access to care by opening primary care clinics where people live, staffing our clinics with experienced and knowledgeable nurse practitioners (NPs), embracing technology solutions that identify issues sooner, and offering convenient options for care, such as walk-in appointments and telemedicine visits. In addition, we are developing partnerships with organizations like the National Minority Health Association to lower the long-term overall cost of healthcare and improve health outcomes for minority and underserved communities. Core to our vision in overcoming the inequities in healthcare is to meet people at their level and then coach people to become partners in their own health.

Of course the story was not entirely negative. Healthcare professionals were true heroes on the front lines of the crisis. The COVID vaccines are saving millions of lives. Can you share a few ways that our healthcare system really did well? If you can, please share a story or example.

During the pandemic, a large number of U.S. patients leveraged the power of telemedicine and were able to visit with their healthcare provider online. At The Good Clinic, we do everything in our power to make it easy for our clients to get the care they need, so offering virtual care is a linchpin of our strategy to improve healthcare access, lower costs, and meet the patient where they are.

Another area where our healthcare system did really well during the pandemic was the collaborative response of the private, public, and government systems to develop and roll out COVID-19 testing capabilities and vaccines. When major systems work together toward a common goal, we can move mountains.

Here is the primary question of our discussion. As a healthcare leader 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.

1. Reduce the cost of care / lower healthcare costs. Our philosophy is that patient and provider-centered primary care with a focus on patient engagement and convenience lowers cost. When it is done well, primary care can deliver a 19 percent lower risk of premature death and a 33 percent lower health care expenditure than patients who only see specialists. Sixty percent of ER visits can and should be shifted to primary care; when there is a $1 increase in primary care services, the return is a $13 cost reduction overall​. To that end, we are launching nurse practitioner-led primary care practices that use tools, systems, technology, and business management services that allow our clinicians to focus on delivering individualized care.
2. Develop patient and provider-centric technology solutions. Technology solutions such as provider-centric EMR, telemedicine, diagnostic innovations and clinical decision support will continue to revolutionize healthcare. Importantly, the first step to enabling health technology to deliver the intended results is recognizing that technology, like the practice of medicine, must work with a person’s life, not without regard for their realities.
3. Put primary care where people live. People are more likely to use primary care when clinics are near their homes, which is why The Good Clinic’s facility size, design, and locations are all thoughtfully designed to increase convenience and improve access to care.
4. Improve healthcare outcomes by providing customized, quality healthcare eservices. Too often, medicine is practiced on people, not with people. We provide a highly personalized approach leveraging our patients’ Personal Activations Measures (PAM), which allows us to customize their unique healthcare style and offer care, coaching, and regular educational opportunities to engage patients in managing their own health.​
5. Improve individual accountability to health. Fifty percent of Americans lack the knowledge, skills, and confidence to be accountable for their health. Accountability means embracing healthier lifestyles, eating less and better foods, increasing activity, taking medicine and supplements as agreed to with the clinician, and educating themselves to make better choices in life overall. The first step is to meet people at their level and use validated tools like PAM to help people begin building the knowledge, skills, and confidence to improve the quality of their lives.

Let’s zoom in on this a bit deeper. How do you think we can address the problem of physician shortages?

The American Medical Association states that there is a 25,000 primary care physician shortage in the U.S., and access to primary care is declining.​ Currently in the U.S., 23 states and the District of Columbia allow “full independent practice” for nurse practitioners, which means that NPs are recognized for their training, knowledge, and experience as primary care providers. The typical nurse practitioner has 10 years of hands-on patient care experience even before they earn their advanced degree to become a nurse practitioner. The Good Clinic is staffing our clinics with experienced and knowledgeable NPs who invest the time to listen to each client. By understanding the client’s life challenges and goals, we are able to deliver more effective care plans. Longer, more comprehensive appointments allow clients ask the questions that help them feel more in control of their health.

How do you think we can address the issue of physician diversity?

Nurse practitioners are a part of the answer toward building diversity into healthcare. Unlike becoming a physician, which requires hundreds of thousands of dollars and 10 to 14 years of education, people can become an NP over an extended period of time by climbing the nursing career ladder one rung at a time. They can start with a basic post-secondary education and begin working as an LPN or RN, then further their education and work as a BSN and then return to school for a PhD to become a Doctor of Nursing Practice. It takes people between eight and 15 years to be a fully licensed NP, which includes working with patients and gaining experience, knowledge, and skills while earning a living. Because of this, even people from modest means can become NPs.

How do you think we can address the issue of physician burnout?

Patient satisfaction with the U.S. healthcare system is at an all-time low, and physician burnout has been made worse by the COVID-19 pandemic. Today, healthcare is designed for uniform interactions, treatments and interventions, regardless of an individual’s unique needs. Yet physicians want to focus on what matters the most — patient care. At The Good Clinic, we think focusing on patient-driven care is not only good for the client, it’s also good for the clinician. Building lasting relationships with our clients and offering high-touch, low-cost methods of prevention and healing has the potential to shift the scope of the U.S. healthcare system from sick-care to well-care. And that’s good medicine for us all.

What concrete steps would have to be done to actually manifest all of the changes you mentioned? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

Personal accountability is a core component of enhancing the U.S. healthcare system. Life choices have a cost for everybody. 1) One approach that offers promise is designing a healthcare system that supports cost-sharing for lifestyle choices. 2) Several companies offer their employees the opportunity to participate in nutritional counseling, stress management, and exercise programs and then reduce the cost for those who participate. Others reward employees who are active and measure their daily activity. 3) Community health programs also offer much promise. New York City Mayor Bloomberg outlawed supersized fast-food drinks and focused the city on reducing the number of people partaking in smoking secession programs. 4) Another concept is to recognize that the illness burden is not shared equally. The sickest people in our communities may need higher levels of care than our current system can support. We could enhance our current system by adding specialized care teams that focus exclusively the segment of people who use $60 thousand to $2 million in care resources each year. More than 70 percent of these costs are related to hospitalization, and 50 to 90 percent of these hospitalizations could be avoided through the delivery of more timely personalized care interventions.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

I would encourage people to take a little better care of themselves. Even small changes help your attitude, your relationships, and your health. The human body is an amazing thing. If you reduce the stressors in your life, your body will respond and deliver better health — both physically and mentally.

How can our readers further follow your work online?

You can visit thegoodclinic.com or mitescoinc.com and follow us on all our social channels, which you can find on our websites and at the following links: The Good Clinic Facebook, The Good Clinic LinkedIn, The Good Clinic YouTube, The Good Clinic Instagram, Mitesco LinkedIn and Mitesco YouTube.

Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.