Encore! EP225: Why, Right Now, It Is No Longer Optional to Suck at Patient Centricity, With Joe Selby, MD, MPH, Former Executive Director of PCORI

In this Encore episode 225, Stacey Richter replays her conversation with Joe V. Selby, MD, MPH, former executive director of PCORI (the Patient-Centered Outcomes Research Institute), about why patient centricity is no longer optional.

WHAT YOU'LL LEARN

✅ Why patient-centric care often leads to lower, not higher, utilization

✅ How shared decision making changes the default course of treatment, using back surgery as an example

✅ What PCORnet is and how it links health system data with claims data for better research

✅ Why getting health systems to actually use PCORI's research findings is the hardest part of the job

✅ Why short-term results so often win out over long-term change in health care culture

WHY THIS MATTERS

Joe Selby makes the case that patient-centric care isn't just the right thing to do — it's often the more cost-effective thing to do, since involving patients in shared decision making tends to reduce unnecessary utilization rather than increase it. PCORnet, the research network Selby helped build, links clinical data from health systems with claims data to answer questions that matter to patients and their bottom line, not just academic curiosity. His biggest frustration: getting that evidence to actually change entrenched clinical habits, since durable culture change is so much harder than achieving a short-term result.

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

🔗 Healthcare Industry Acronyms and Terms

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00:00 Introduction

05:36 Can payers afford to make health care patient-centric?

05:59 "If you make care more patient-centric … you actually see decreases in utilization."

06:32 Shared decision making.

09:59 "What gets in the way of implementing good evidence?"

10:08 A study involving community health workers.

11:26 Default care and back surgery.

13:45 "There's just a lot of habits like that in clinical care that aren't backed up by evidence and can be undone with good evidence."

14:23 How Dr. Selby figures out what the patients want and what outcomes to focus on.

14:48 Looking for evidence gaps.

16:26 What PCORnet is and what they're doing.

18:15 "To do really good quality research, you have to be able to link the data from health systems … to data from claims."

19:32 "We're asking questions that matter to them, to their bottom line, and to their patients."

19:37 What the main goal of PCORnet is—what or where?

21:26 Giving and getting data as a health system.

22:12 Studies that have come from PCORI's queries.

25:31 "It's very important that the systems … appreciate that PCORnet is active in their midst."

26:09 "It's hopefully a culture-changer, driving toward more collaboration and toward … finding common ground between people who are asking purely clinical questions and people who are asking the more practical questions."

26:28 What frustrates Dr. Selby the most.

28:39 Turn the Ship Around!—a book about short-term evaluation and short-term results vs long-term change.