Can We Leave the Healthcare System Better Than We Found It?

Physicians face a growing number of challenges today, and many of them have nothing to do with building relationships and treating patients—the primary reason many chose to practice medicine in the first place. Instead of spending more time getting to know their patients, which is key to building trust and improving outcomes, doctors are inundated with administrative tasks, paperwork, and ensuring they check RVU boxes that arguably reward quantity over quality and over-the-top documentation over deliverables.

Adding to the growing list of hurdles to simply being a good doctor is the looming cloud of burnout affecting an astounding 63 percent of physicians today, unprecedented staffing shortages that are only slated to get worse (up to 124,000 fewer physicians by 2030 worse, according to the American Medical Association), and a faulty fee-for-service model that incentivizes tests and procedures over more quality metrics like effectively managing disease and keeping patients out of the hospital.

Can we leave healthcare better than we found it? Or is the system simply too far gone to revive?

Overcoming the Challenges in Healthcare Today: 2 Things to Remember

Dr. Elliott S. Fisher, Professor of Medicine and Health Policy at The Dartmouth Institute and Senior Fellow at the Institute for Healthcare Improvement, is no stranger to not just identifying the many challenges in healthcare delivery but actually doing something about it. On ChenMed’s Faisel and Friends podcast, which discusses the state of healthcare today, he shares his experience lobbying for policy change, peels back the many layers of the complex challenges facing physicians and clinical care teams today, and shares some promising insight on how physicians can be the change they wish to see in the healthcare delivery world.

Can we leave the healthcare system better than we found it? Perhaps—but it will take work. Here are two things to consider that might be an impetus for you to take matters into your own hands and be an agent of change in your field.

We’re Stronger Together.

Enacting change by yourself can feel overwhelming and impossible. This is why Dr. Fisher suggests linking up with other physicians and joining physician networks who are already aligned and working toward enacting positive change in the field.

“I grew up with a strong sense that my mission in life was to make the world a better place, but not knowing how to do it that was so uncomfortable,” Dr. Fisher recounts. “The thing that made it possible—while a student and then a resident and [thereafter]—was having friends and colleagues who all decided we would work together to do something about [these challenges]. We founded a medical school newspaper. I joined a public health coalition while a resident. I don’t think I would’ve done it by myself, but I think it was the fun of working with other people committed to making a difference and then realizing that you could, too.”

Just one of the positive changes he directly influenced was the medical school committing to prioritize and pay closer attention to minority admissions, ensuring a more diverse student body. “Working with other passionate people and positive enforcement really helped carry things forward,” Dr. Fisher shares.

Be Willing to Step Outside of Your Comfort Zone.

Throughout history, institutional and systemic change pioneers experienced great opposition, vilification, and even persecution. While hailed a hero today, the incredible Dr. Martin Luther King, Jr. was widely disliked at the time, with 75% of Americans disapproving of the civil rights leader in real-time. This means going against the grain to enact positive change may, at best, cost you your comfort and, at worst, cost much more. But before you protest in the streets and disrupt the peace, the first step could simply be making an uncomfortable phone call and offering a helping hand to someone in a position to make changes, according to Dr. Fisher.

“I was a fellow at the University of Washington and [contacted someone in leadership] a million layers above me who was appointed to run a committee on dealing with uncompensated care. I just called him up and said, ‘Could you use some help?’ He could’ve said no, but he said sure!” As a result, Dr. Fisher wrote a draft of the report to mitigate the financial burden of hospitals primarily caring for poor, uninsured people. The positive feedback from people saying, “Sure, we’d love your help,” Dr. Fisher reiterates, is a powerful catalyst to keep chiseling away at the status quo that continues to adversely affect access to and quality of care today.

Dr. Fisher asserts that a full capitation or value-based payment model is a surefire way to improve the quality of care as well as patient outcomes across the board. “But it requires shifting to a system that lets the doctors focus on the care, paying attention to and building the capacity to identify who is managing a population—not just the patient in front of you.”

Listen to the full episode of Faisel & Friends with Dr. Elliott S. Fisher, Professor of Medicine and Health Policy at The Dartmouth Institute and Senior Fellow at the Institute for Healthcare Improvement. Our conversation revolves around improving the American healthcare system for patients, physicians, and the public. Dr. Fisher also recounts his experience with lobbying for advocacy and policy change. Faisel and Friends is a primary care podcast that discusses the state of healthcare in America. Subscribe now to receive the latest episodes!