Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

The crumbling walls of health care is a good thing

James C. Salwitz, MD
Policy
August 18, 2015
Share
Tweet
Share

There was a doctor. The doctor had an office. In the office, he had a practice. The doctor worked hard, was honest, smart and compassionate. He took care of many patients, everyday, and helped many people. The people paid with cents, checks, and chickens. He was solo, alone, by himself. It was good.

There was a hospital, near the doctor. It was an important hospital. It took care of many patients, everyday, and helped many people. The hospital was alone, by itself. It was good.

And, there was a nursing home.

And, there was a pharmacy.

And, there was an insurance company.

And, there was big pharma.

And, there was a medical school.

There were nurses, health planners, administrators, architects, system analysts and many other smart, compassionate, hardworking people. They all took care of patients, everyday, and tried to help many people. They were each all alone. In boxes. In silos.

Nonetheless, even though they did their best, even though they deeply cared, despite all their very hard work, it came to be that the people realized it was not good.

There was waste, mistakes, and confusion. There was duplication, anger, and fear. There was pain, suffering, and death. Patients got sick and the harder all the people in all their silos tried, they made everyone sicker.

So, the people said, we have to get together. We have to talk. We have to think and plan.

It was a good idea. A bright light. However, there was a terrible problem.

The people did not trust each other. The doctors thought everyone was out to get them. The nurses got no respect. The administrators could not get anyone to listen. The nursing facilities were an afterthought. The drug industry was about profit. The medical schools were not sure what to teach and could not get any patients for research. Financiers and industrialists believed the whole thing was expensive dysfunctional chaos. Politicians were a punch line. No matter what good works the insurance companies did, the people hated them more. Everyone was frightened of the lawyers, who though they tried very hard to connect, created obstructive bureaucracy.

Nevertheless, this was a crisis: Something had to change. Therefore, the people sat down at a big table. It was a very big table. It was so big that the people at the each end of the table had their feet in the water of different oceans. The people started to talk.

They did not talk, at first, about sick patients, cost centers, information systems, certificates of need, personalized medicine, blueprints, bond ratings, staff ratios, Obamacare (oh, maybe a little) or critical research. They did not start to rebuild.

They talked about language. They talked about priorities. They shared their dreams. They learned about each other, and what each silo, each box, was trying to do.

Why did the lawyers love contracts? Why did the planners need metrics? How do computer designers write? Why does the CFO love EBITDA? What in the world is translational medicine? How do insurance companies work and what do, they really want? How does government and health policy happen? What does a doctor feel when it is 6:45 p.m. and they are 90 minutes behind, and they haven’t seen their family in a week and the patient in front of them takes out a long list and there is a scream in their waiting room and the EMR crashes?

A marvelous thing happened. As all the people in all their loneliness learned about each other and what each was trying to do for patients and the communities they loved, they learned that they had much in common. They could help each other. Team meant something broader, more universal and powerful, than just the one person in the next room. Together they had an incredible opportunity to take all the great things they had built alone and, as one, change the future.

Then, there were no more boxes. Everyone left their safe isolating destructive silos. They became one immense, powerful caregiver with capacities, and energies never before dreamed. Colleagues, collaborators, and compatriots. They spoke one language; the language of healing, and health. The language of balance, efficiency, and empowerment. The language of exploration, research, and innovation. The language of hope.

And the walls came tumbling down.

James C. Salwitz is an oncologist who blogs at Sunrise Rounds.

Image credit: Shutterstock.com

Prev

Improve the patient experience with these 5 simple ideas

August 18, 2015 Kevin 4
…
Next

The story of how one physician recovered from burnout

August 19, 2015 Kevin 92
…

Tagged as: Hospital-Based Medicine

< Previous Post
Improve the patient experience with these 5 simple ideas
Next Post >
The story of how one physician recovered from burnout

ADVERTISEMENT

More by James C. Salwitz, MD

  • Each line on the radiology list is a patient’s line in the sand

    James C. Salwitz, MD
  • The broader mission for hospice care

    James C. Salwitz, MD
  • Is the medical profession at its end?

    James C. Salwitz, MD

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • Why health care replaced physician care

    Michael Weiss, MD
  • Turn physicians into powerful health care influencers

    Kevin Pho, MD
  • Health care is not a service commodity

    Peter Spence, MD, MBA
  • Why the health care industry must prioritize health equity

    George T. Mathew, MD, MBA
  • Health care workers should not be targets

    Lori E. Johnson

More in Policy

  • How cross-sector collaboratives cut health care costs

    Christine Schuster, RN, MBA
  • Why health care accountability demands system readiness

    Tiffiny Black, DM, MPA, MBA
  • How Medicare reimbursement hurts independent physicians

    James Albert, MD
  • Medicare physician pay has fallen 33 percent since 2001

    Kayvan Haddadan, MD
  • Health insurance coverage loss threatens sick children

    Mansi Kotwal, MD, MPH
  • Independent physicians are missing from health care policy

    Scott Tzorfas, MD
  • Most Popular

  • Past Week

    • How to improve protein absorption after gastric bypass

      Kevin Huffman, DO | Conditions
    • Medicare physician pay has fallen 33 percent since 2001

      Kayvan Haddadan, MD | Policy
    • DOT ruling protects peanut allergies but not eggs, sesame, or milk [PODCAST]

      The Podcast by KevinMD | Podcast
    • Telemedicine as a career, not a side gig

      AIR Physician Academy | Physician
    • Why physicians miss business owner stress in patients

      Timothy Lesaca, MD | Physician
    • Reclaiming the lost art of the physical exam

      Ann Lebeck, MD | Physician
  • Past 6 Months

    • I Googled my own name and a corporate clinic I’ve never worked at appeared [PODCAST]

      The Podcast by KevinMD | Podcast
    • Primary care crisis requires new training and skills

      Justin Oldfield, MD | Physician
    • How corporate health care ruined the medical profession

      Edmond Cabbabe, MD | Physician
    • Why nature-based medicine is the future of health care

      John La Puma, MD | Education
    • The cost of chaos in medical malpractice litigation

      Howard Smith, MD | Physician
    • Why our health care system is failing chronic disease patients

      Beata Pasek, EdD | Conditions
  • Recent Posts

    • How GLP-1 medications compare to bariatric surgery

      Quoc Dang, DO | Meds
    • Overcoming physician burnout during medical residency

      Jillian Rigert, MD, DMD | Physician
    • How moving from nursing to medicine improves oncology care

      Max Jared Bajer, RN | Education
    • Why hospitals delay action on impaired physicians

      Paul B. Hofmann, DrPH, MPH | Physician
    • Lifestyle, mindfulness, and the neuroscience of happiness

      Kayvan Haddadan, MD | Physician
    • When normal creatinine hides post-operative kidney injury

      John Erbey, PhD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 10 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • How to improve protein absorption after gastric bypass

      Kevin Huffman, DO | Conditions
    • Medicare physician pay has fallen 33 percent since 2001

      Kayvan Haddadan, MD | Policy
    • DOT ruling protects peanut allergies but not eggs, sesame, or milk [PODCAST]

      The Podcast by KevinMD | Podcast
    • Telemedicine as a career, not a side gig

      AIR Physician Academy | Physician
    • Why physicians miss business owner stress in patients

      Timothy Lesaca, MD | Physician
    • Reclaiming the lost art of the physical exam

      Ann Lebeck, MD | Physician
  • Past 6 Months

    • I Googled my own name and a corporate clinic I’ve never worked at appeared [PODCAST]

      The Podcast by KevinMD | Podcast
    • Primary care crisis requires new training and skills

      Justin Oldfield, MD | Physician
    • How corporate health care ruined the medical profession

      Edmond Cabbabe, MD | Physician
    • Why nature-based medicine is the future of health care

      John La Puma, MD | Education
    • The cost of chaos in medical malpractice litigation

      Howard Smith, MD | Physician
    • Why our health care system is failing chronic disease patients

      Beata Pasek, EdD | Conditions
  • Recent Posts

    • How GLP-1 medications compare to bariatric surgery

      Quoc Dang, DO | Meds
    • Overcoming physician burnout during medical residency

      Jillian Rigert, MD, DMD | Physician
    • How moving from nursing to medicine improves oncology care

      Max Jared Bajer, RN | Education
    • Why hospitals delay action on impaired physicians

      Paul B. Hofmann, DrPH, MPH | Physician
    • Lifestyle, mindfulness, and the neuroscience of happiness

      Kayvan Haddadan, MD | Physician
    • When normal creatinine hides post-operative kidney injury

      John Erbey, PhD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The crumbling walls of health care is a good thing
10 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...