The Dogma of the Triple Aim

Submitted by hci3-usr on Saturday, April 30, 2016 - 04:45

Newtown, CT – April 30, 2016

When Dick Hoyt’s son was born, many of the physicians that examined the child imputed their values instead of respecting the family’s intrinsic values. Fortunately, they only paid attention to their values – Over the years, team Hoyt has become an inspiration for families struggling with various afflictions, and for many others, for good reason. That’s because when Rick Hoyt was born with cerebral palsy there wasn’t much hope that, in the words of the doctors, he would be much more than a vegetable. The parents, however, had noticed that the child’s eyes would follow them around and they persevered in finding answers, steeped in the belief that a life, however weak, has value. Rick went on to graduate from Boston College, a feat rarely attained by a vegetable, and convinced his father to start running with him, which Dick agreed to. And since then they’ve run dozens of marathons and even six iron man triathlons, something that few men have accomplished, let alone a team composed of an aging man and his paralyzed son. Beyond the love that clearly animates the father to undergo such extraordinary acts for his son, there’s a profound lesson on how important it is to never impute one’s values on another. And yet, today, and for the past several years, a dogma has animated policymakers and ivory tower dwellers, and they have imputed the values of that dogma on everyone. It’s called the Triple Aim, a misguided policy if there ever was one, because in health care there should only be one aim, to care for the patient, one person at a time.

What this means to you – We get caught up in slogans because they’re easy and lull us to believe that a few simple words translate into simple action that yield good results. But they rarely do. And the simple truths that are often more difficult to put into practice than the simple slogans, get swept aside. So we must remember this simple truth: that caring for an individual as a person, with dedication, humility and compassion is the only way to achieve their goals. Of course those who espouse the dogma of the Triple Aim never really speak about the patient’s goals. Instead they speak in generalities of “population health”, “per capita costs”, “experience of care”, all of which strip the patient, the person, of any identity, and converts them into a number, a statistic. And in doing so, they then make it a lot easier to start imputing their values on patient values and hence sweep aside those patients’ intrinsic values. Making the health care system truly patient-centric is anathema to most in the industry because it requires the system to humble itself in front of patients. It requires it to structure itself around the patient’s needs instead of bending the patient’s needs to those of the system. If Dick had done that to Rick, there would never have been a Team Hoyt, or what it has inspired to millions. Dick didn’t need a Triple Aim to figure out what’s right for Rick, and neither do clinicians to figure out what’s right for their patients. As regulators and others continue to scrutinize the mega mergers of the “would-be-Triple-Aim-Champions”, they should note that few patients want to be a Triple Aim statistic of a population health behemoth.


Francois Sig


Francois de Brantes
Executive Director