Dr. Wendy Tong on Coronavirus Outbreak and Healthcare System in the US
Alex Romanovich interviews Dr. Wendy Tong, an internal medicine physician who is out to transform the aging experience through a new model of home care coupled with innovative technology that will impact the daily lives of seniors and their families.
Wendy is the CEO and Founder of Wendy’s Team, a home care agency founded in 2016 that has an established presence in Denver and Boulder, Colorado. Wendy shares the trials and tribulations of putting aside a high paying executive position to go out on a limb to pursue a dream and start her company.
She also shares how her work with Wendy’s Team has had a direct impact on her ability to care for her father. Wendy’s father receives hospital-level care in his home in Hong Kong. Wendy talks about how the recent protest activity and coronavirus in Hong Kong have impacted her father’s medical care and her ability to care for her father from across the globe.
Alex: Wendy, welcome to our studio! We are very excited to talk to you about so many things in your life. Our audience is always interested in learning more from global entrepreneurs with interesting backgrounds, and their accomplishments… You’ve had a very interesting career, a multicultural background, and a very dramatic experience with your family. You are a single mom of three wonderful kids, and also care remotely for your ill father who is in Hong Kong. How do you accomplish this and what drives you?
Wendy: Thank you Alex for inviting me to join you today and more importantly thank you for acknowledging my family at the beginning of your podcast because in answer to your question, what drives me in doing all that I do is the overarching motive to leave the world a better place for my children to grow up into. There’s a “pay it forward” element too where in being of service to others, I honor those whose shoulders I stand upon. I grew up in a family of privilege, I am the third generation of entrepreneurs. My grandfather was knighted by Prince Philip and my father is a very successful entrepreneur with a global enterprise. I grew up in Hong Kong when it was still a British colony and my peers who were mostly expatriates, were always from all over the world. I’ve had an excellent education and my career has always enabled me to fulfil the declared intention of being a woman of impact and influence. I made this specific declaration in my first year of college and it has shaped the trajectory for the rest of my life.
Alex: Let’s talk a little about your earlier career with Managed Care and US-Based Hospital Systems. As we are in the election year and are considering many options being talked about by the candidates, In what shape are we in terms of the quality of care as designed vs. as delivered to US general public? What can you say about the prognosis of the US Managed Care for the immediate future? Will Medicare-for-all work in the USA? Should it?
Wendy: Sadly Alex, the US when compared to countries of similar size and wealth (think G13), has an abysmal scorecard. The US ranks dead last (pun intended) on the HAQ Healthcare Access and Quality Index. This score is based upon the idea of amenable mortality, meaning a death that could have been prevented by timely and effective health care. The lower the score, the poorer quality and access to healthcare. The US scores an 88 whereas all other comparable countries score above 90. And yet of all the Nobel Prize Laureates in Medicine in the past twenty years, more than half are from the US. So we have a dichotomy of having the worst healthcare and the best of medical knowledge in the US. How is that so? I believe it all comes down to access to healthcare. 37% of Americans report barriers to care compared to 4% in the UK. The barriers to access are pervasive and encompass geographic, social, economic, cultural, educational, you name it…ultimately, it means that most patients get too little care too late. As a physician, treating an illness at an advanced stage, is more difficult, carries a poorer prognosis, and is much much more costly than if the care had been provided at an early stage or could have been prevented in the first place. The US lags behind in preventive care and we have the highest admission rates for preventable conditions.
So how does managed care fit into all of this? I believe that there is a very important role for managed care and that managed care is not going away. When I was a physician executive at Anthem Blue Cross, my job included two main areas of oversight: first, quality management which included access to care and tracking the fulfillment of preventive care guidelines in order to optimize health outcomes. The second was in utilization management. Did you know that 5% of the population account for more than half of the healthcare spending? The UM process assesses the appropriateness, cost-benefit, and efficacy of medical treatments in order to contain healthcare costs and protecting limited resources. I believe that without managed care, access and cost containment would run amuck and leave us in a worse situation than we are in already.
As for Medicare-for-all, I believe it will work but the impact on health outcomes will be more noticeable in rural areas and in communities where seniors are of lower socioeconomic level and have more limited access to healthcare than in urban and wealthier areas. This statement draws upon my experience in rolling out Anthem’s Medicaid expansion in northern California in 2014. Coverage increased from 230K to 435K, from 5 to 18 counties because of the expansion into rural counties. Now, after some years after the rollout, we have the health outcomes data to note that the improvement in access to preventative care and health outcomes related to chronic diseases such as asthma, diabetes, high blood pressure is markedly greater in the rural than urban areas. Launching the Medicaid expansion was expensive with a price tag of $738M in California but in the long run, I do believe that the cost savings from improved chronic disease management will make the investment worthwhile.