Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • 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

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.

ADVERTISEMENT

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

Post navigation

< 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

  • Online eye exams spark legal battle over health care access

    Joshua Windham, JD and Daryl James
  • The One Big Beautiful Bill and the fragile heart of rural health care

    Holland Haynie, MD
  • Why health care leaders fail at execution—and how to fix it

    Dave Cummings, RN
  • Healing the doctor-patient relationship by attacking administrative inefficiencies

    Allen Fredrickson
  • The hidden health risks in the One Big Beautiful Bill Act

    Trevor Lyford, MPH
  • The CDC’s restructuring: Where is the voice of health care in the room?

    Tarek Khrisat, MD
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Facing terminal cancer as a doctor and mother

      Kelly Curtin-Hallinan, DO | Conditions
    • Online eye exams spark legal battle over health care access

      Joshua Windham, JD and Daryl James | Policy
    • FDA delays could end vital treatment for rare disease patients

      G. van Londen, MD | Meds
    • Pharmacists are key to expanding Medicaid access to digital therapeutics

      Amanda Matter | Meds
    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast

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 11 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

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Facing terminal cancer as a doctor and mother

      Kelly Curtin-Hallinan, DO | Conditions
    • Online eye exams spark legal battle over health care access

      Joshua Windham, JD and Daryl James | Policy
    • FDA delays could end vital treatment for rare disease patients

      G. van Londen, MD | Meds
    • Pharmacists are key to expanding Medicaid access to digital therapeutics

      Amanda Matter | Meds
    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • 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
11 comments

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

Loading Comments...