It is clear to most of us who practice medicine that the medical system is at a crossroads unlike any other in recent history, between competing crises of uncontrolled medical costs, escalating administrative burdens, consolidation and employment of physician practices, burnout, and the rapid development and entrance of new, largely untested technologies. I am sure that I am not alone as a physician who wonders what will the medical system look like in the decades to come when my family or I need it. Who will be there to care for us after we have spent a lifetime caring for others? Of course, the truthful answer is “I dunno,” but every cloud has its silver lining, and there is a unique opportunity to rise to this challenge as well and reimagine medical practice for the decades to come.
Despite the trends of physician employment and consolidation, because of our education and unique knowledge of how to translate and deliver scientific thought into a treatment plan for human beings, physicians still wield significant power in administrative decision-making, which sometimes we forget. Furthermore, in medical administration, physicians have a much longer tenure than the average administrator/executive and are ideally suited to spearhead long-term initiatives. I have started and built practices and led large groups and departments. Now in my role as a CMO, I have seen that almost universally, medical institutions do not make decisions without significant physician buy-in. Herein lies our first and most important opportunity to drive change for our patients and our fellow physicians.
The opportunity for change will not be seized if physician leaders are not imbued with a growth mindset. By nature and practice, our work follows predictable and safe patterns and workflows built around long-established guidelines, which are helpful for daily practice efficiencies but detract from the long-term progressive change at a leadership level. Physician leaders, executives, and professional society leadership are responsible for experimenting with disruptive and novel models of care and practice in the real world. Innovation sections and departments have been erected but are often nebulous in scope and prerogative. A better model might be to operationalize the process of innovation, where the many hurdles to change within medical institutions are alleviated, and the department of innovation is a real-world clinical translation proving ground. With courage and support from our community and institutions, we can test and implement (or not) new technology more rapidly.
New technologies, software, and devices are being developed exponentially by many companies seeking to access a part of the gigantic health care market. Most do not begin to meet the numerous and stringent criteria for medical use, while a few will be transformational. Our patients clearly want some of the ease of consumer electronics companies in how they access and interact with health care. It is unrealistic to expect this trend to dissipate as our world becomes increasingly digital. Daunting as it may be to explore and test potential solutions in a real medical environment, only through practical and collaborative innovation – with processes, devices, and software – will we be able to solve some of the greatest challenges in medical practice today. We are all trained to be lifelong learners, and because we know both the art and science of medicine, we can and need to lead the health care system to a more sustainable future.
Jay Shah is a cardiologist and health care executive.
