Value-Based Care

The Pursuit of Simplicity and the Right Amount of Less

By embracing the art of simplification—by subtracting the extraneous and focusing on the essential—we can truly deliver on the promise of value-based care.

The Art of Simplicity:

Driven by the admirable goal of enhancing patient well-being, healthcare providers find themselves entangled in a web of complex problems, searching for solutions in an intricate healthcare landscape.

It is within this context that the wisdom shared by Dr. H. Gilbert Welch in his book 'Less Medicine, More Health' resonates profoundly, urging us to reconsider our approach to healthcare in the face of complexity.

In our quest improve health outcomes, we often succumb to the allure of additive solutions, overlooking the power of subtraction. This tendency, as observed in a study published in Nature →, reveals a cognitive bias towards favoring additive ideas, even when subtraction might offer a more effective path forward.

Consider the analogy often attributed to Mark Twain: "I apologize for such a long letter—didn’t have time to write a short one." Simplifying demands effort, patience, and a willingness to delve deeper. It challenges us to unravel complexities, peeling away layers to reveal the core issues at hand.


The Virtue of Subtraction:

Subtraction, as emphasized by researchers like Leidy Klotz, is not merely about doing less; it's a nuanced process that demands thoughtful consideration.

In healthcare, this translates into critically evaluating our interventions, treatments, and diagnostic approaches.

It requires us to contemplate not only what to add but also what to subtract, recognizing that the elimination of unnecessary procedures and medications can be as impactful as their addition.


The Relevance in Value-Based Care:

In the realm of value-based care, where the focus is on optimizing patient outcomes while minimizing costs, the art of simplification gains paramount importance.

The principles outlined by Dr. Welch and supported by research findings underscore the need for a paradigm shift. Healthcare providers must move beyond the impulse to add more interventions and treatments and instead adopt a discerning approach. By embracing subtraction, we can identify inefficiencies, reduce unnecessary costs, and enhance the overall quality of care.

In his book, Dr. Welch challenges the prevailing assumptions about medical care and advocates for a more cautious approach to medical interventions. He argues that the healthcare system often overdiagnoses and over-treats patients, leading to unnecessary harm and inflated costs.


Key points from the book:


1. Medicalization of Ordinary Life:

Dr. Welch discusses how aspects of normal human experiences are often medicalized, leading to unnecessary treatments and medications.

2. Overdiagnosis:

The book explores the problem of overdiagnosis, where people are diagnosed with conditions that will never cause symptoms or death in their lifetime. This leads to unnecessary stress, treatment, and costs. 

3. Overtreatment:

Dr. Welch emphasizes how overtreatment, including unnecessary surgeries, medications, and medical procedures, can be harmful and may not provide significant benefits. 

4. Screening:

The book questions the widespread use of screening tests, suggesting that while they can detect diseases early, they can also lead to overdiagnosis and unnecessary treatments. 

5. Assumptions about Benefits:

Dr. Welch challenges the assumptions about the benefits of various medical interventions, encouraging readers to critically evaluate the true impact of these interventions on their health.

6. Assumptions about Harms:

Similarly, he discusses the potential harms associated with medical interventions, highlighting that all treatments carry some risks and these risks need to be carefully considered.

7. Patient Empowerment:

Dr. Welch advocates for a more active role for patients in their healthcare decisions. He emphasizes the importance of informed decision-making, where patients understand the potential benefits and risks of medical interventions and actively participate in the decision-making process.


Navigating the complexities of healthcare requires a departure from the conventional mindset that often leans towards additive solutions.

As healthcare providers and professionals at HNI Healthcare, it is imperative that we heed the wisdom of Dr. Welch and the insights from recent research.

By embracing the art of simplification—by subtracting the extraneous and focusing on the essential—we can truly deliver on the promise of value-based care.

In this journey, there are no shortcuts, but the rewards are immense: improved patient outcomes, streamlined processes, and a healthcare system that is both effective and efficient.



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hni healthcare waste calculator

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