Leading innovations in prevention and cure.

Medical organizations could and should be contributing to improving the health and sustainability of individuals, families, businesses, communities and governments. Their failure is reflected in the continual rise of health care costs along with the incidence of chronic diseases and the suffering and poor quality of life they beget. The situation is driving large nonmedical organizations to institute policies or programs to reduce their medical costs. A common dilemma for leaders of medical organizations who wish to achieve breakthrough improvement is two-fold: how to proceed and where to obtain the necessary money. Money can be recovered by focusing on the treatment of chronic conditions that account for up to 75 percent of medical costs.1 Success, however, requires a shift away from tertiary prevention (i.e., controlling complications with the use of drugs and procedures). Initially, the strategy involves a shift to secondary prevention (i.e., reversing and curing the conditions), and ultimately to primary prevention (i.e., preventing the condition from occurring). Success would be a marked reduction in the incidence of chronic disease and reduced costs. To achieve dramatic results medical organizations will need to be led by effective teams. Their effectiveness will require best practices drawn from three areas: