The relationship between doctors and their patients is a sacred one. For centuries, healers have held an esteemed role in their societies because they were entrusted to advise and act in the best interest of others. It is this trust and understanding that forms the sacred bond between patients and doctors—a deeper connection that transcends any type of transactional relationship.
In the United States, however, we have essentially abandoned the sanctity of the patient-doctor relationship. No matter how much we claim to believe in it—the reality is that a system built on the fee-for-service model inherently pushes doctors and patients toward transactional, economic-based relationships.
Today, however, the wider public still views clinicians with high regard and trust. It is precisely because society has this perception that clinicians are best positioned to lead a transformation in healthcare. But how can they achieve this?
We’ve outlined three areas for clinician involvement to lead the transition of our healthcare system away from a transactional basis towards a broader view that encompasses the social and moral determinants of health.
1. Stand up for moral and ethical business practices
Not every clinician is an owner or has formal leadership titles within their organization, but this does not mean clinician voices are not important. CEOs, CFOs, CMOs, Medical Directors, and other leadership all care about what frontline staff have to say.
If you are a leader, then it’s important to recognize that business practices are often a reflection of the moral and ethical attitudes in any healthcare organization. Pay close attention to the following areas:
Performance metrics: consider whether your organization’s chosen measures really incentivize better care (more healthy days at home and lower out-of-pocket costs) or just better financial performance (RVUs and increased admissions) for the health system.
Serving on a quality and finance committee: large groups and health systems often form committees that focus on quality improvement or financial performance. If you serve on one of these committees, you can influence outcomes.
Demand better for support staff: Clinicians are paid a premium (in salary and in benefits)—but janitors, food and laundry service workers, technicians, and other support staff don’t have the same options. As a clinician, you have the power to demand better for the workers that are critical to patient care and who deserve fair wages as well as benefits.
2. Influence key decision-makers
When it comes to health care reform, the most immediate and impactful changes occur within America’s existing regulatory framework and policy decisions at the state level.
Those wishing to impact public policy should focus on the rulemaking that occurs (often out of the public spotlight) at Centers for Medicaid and Medicare (CMS). What CMS decides is usually filtered out to the broader system, including private insurers. However, physicians through Political Action Committees (PACs) and other lobbying efforts can have a significant impact on how these rules are decided in the first place.
The CMS also decides which factors should be considered to calculate risk adjustment, and this determines what payors and providers get paid in bundled (or “capitated”) payment systems. The current system of risk adjustment is what enables risk-based practices like ChenMed to focus on the long-term health of Medicare Advantage patients. But whether that system will include social determinants of health—and how that risk adjustment would be calculated—will determine whether models like ours continue to thrive.
3. Find your platform and raise your voice
Modern changes to the media landscape along with new technology and social media platforms allow easy delivery of your message of moral transformation and change to the public.
YouTube is perhaps the greatest educational resource ever created by humans. Twitter provides you a direct line of communication to nearly every journalist and media personality in the world. Websites capable of hosting a blog or publishing an online magazine can now be built in hours and maintained for less than the cost of dinner out each month. You can now publish and send out an email newsletter that reaches thousands of subscribers for free.
Whichever platform you choose, use it wisely and be consistent. You’ll be surprised how far your message can go. As Faisel Syed, Chenmed’s National Director of Primary Care said: “If you don’t use these tools to communicate with policymakers, your peers, and the public, then others will—others already are.”
Want to learn more about the moral determinants of health and how clinicians can lead a transformation in healthcare? Download our eBook to get more insights on how clinicians can mobilize and take action.
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