The Human Face Of Healthcare
Gene Beyt, MD, MS
George Mastorakos
Congress has repeatedly failed to repeal and replace the Affordable Care Act. In October 2017, President Trump unilaterally signed away the subsidies that help many who struggle to pay for healthcare. In the middle of this chaos, a late-night talk-show host did us all a favor. Jimmy Kimmel willingly put his infant son’s face on the public debate about healthcare access and quality. The heated debate continues among presidential candidates in 2019. Our political and healthcare leaders need to understand why this is important.
Leaders must realize our prevailing system of paying for and delivering care is performing as it was designed. It was not designed for treating the person as well as the disease, or for improving patient access to sources of treatment, or for increasing the value of care delivered. It was not designed to allow patients to be partners in their care decisions. Nor was it designed to have a sustainable cost curve. Errors in care have been listed as the third leading cause of death in this country, with depression and burnout among the caregivers to the level of physician suicides.
Simply stated, the present industry is at odds with its purpose. Redesign of our health system must begin with the human beings rendering and receiving care. Political and organizational leaders need to answer a question basic to the purpose of healthcare. Does the system have the ability to make practical decisions that lead to human health and flourishing, and to the welfare of their human capital—patients, families and workforce?
The current payment systems and work-of-care designs do not create the conditions for the healthcare workforce to find meaning in their work, and in doing so, for the patients to have memorable experiences. Necessary to achieving healthcare’s purpose is the caring for the caregiving workforce. Their positive emotion and positive care processes are good for everyone's health, as they will better care for the health of the patients and improve the value of care delivered.
To do this, we must reframe the problems, changing our mindset from negative to positive. Our healthcare organizations and payment systems must be redesigned as positive businesses if healthcare security is to return and grow.
Members of the healing professions work in situations of opportunity and need for compassion, joy, thriving and well-being. The majority of us want to serve and make a meaningful difference. We don’t want care to be painful, fragmented, costly, inaccessible, or disconnected from human need. We want to care for the person, meeting them where they are, fostering their health and wellbeing. It’s why we chose to work in healthcare.
And we want our leaders to have the same compassion and goals, especially for patients denied needed care, and those whose care exacerbates their suffering rather than alleviates it. We want leaders who are courageous enough to transform the system and promote a positive healthcare culture.
This requires two interwoven solutions. A new kind of leader, who is wise and compassionate enough to create a positive healthcare industry. And a different kind of science, which fosters innovations in the work of care with patient as co-designer of their care. The simple reality is that both solutions begin with empathy.
The different kind of leader is not the next generation of administrator or politician, and is directly opposite the narcissist. They role model the pursuit of moral good and human flourishing, having the capacity to be other-centered, behaving with empathy and relationality—dare we say, generosity. They know how to build trusting and respectful connections with others, how to have an awareness of their own thought processes and limitations, and how to work with the complexity of the healthcare system and deploy the needed human-centered redesign processes.
These leaders understand the deeper meanings of health and care, as well as policy and business. They prioritize, offer optimism and a positive work and caring vocabulary. They have constancy of purpose, frequently asking, “Where is the patient in this?” And they invite the patients into the improvement and policy conversations. With wise leadership fostering a positive culture, the workforce can create meaning in their work lives, and offer new and innovative approaches to the design of their work so people don’t hurt so much.
To this end, both leaders and followers alike need the tools and the supporting science to courageously lead healthcare into a positive future.
The culture of healthcare was initially founded on linear thinking within professional silos and authority gradients, with patient as passive recipient of expert recommendations and technical interventions. And many current leaders continue to foster this culture. Efficiency, data collection and market competitiveness are given precedence over patient care and engagement, especially within this uncertain repeal and replace payor environment.
Conversely, sustainable solutions in healthcare transformation have many interconnected and interlocking parts, and the needed redesign is difficult to describe to those who are focused on one-industry problems looking for one-industry solutions.
Case in point: some organizations have hired a physician to be in charge of reducing workforce burnout. No matter how many sticky notes encouraging resilience the healthcare worker sees on the mirror every morning, or how many lunch seminars are attended, the lack of attention to culture, patient and workforce perspective, system design, human emotion, and problem reframing will result in returning the worker to the same negative space each day.
The science of design thinking is fundamental to positive healthcare policy and business because it offers a different lens on transformation. It encompasses an applied innovation framework that prioritizes empathy, involves diverse and collaborative teams that include patients, and encourages an action-oriented prototyping of innovative and affirmative business practices. It fosters a broader understanding of health and care, allowing for identification of core problems that need to be solved at every level and in every segment of the industry.
The key focus is on human beings connecting with other human beings to build learning communities of engaged policy-makers, patients, and compassionate caregivers. Clinical outcomes, worker satisfaction, patient experience, and performance results will all improve.
A primary care physician involved in a positive redesign of his clinic caring for the underserved put it this way: “Some human touches I have noticed in our clinic over the last few months are heartfelt laughter among patients and staff while handling disease and life changes, smiles and kindness in the atmosphere even during the most tense of times, side conversations focused on raising the bar for our approach to patient care, questions of why we function in certain ways and if it can be improved, and innovation in clinic-patient communication to raise satisfaction for every patient every visit.”
The human face of healthcare offers a very different and powerful perspective. The work of the policy-maker, the work of the caregiver, and the work of the patient have to be different by design—designed with empathy.
Jimmy Kimmel’s son would be pleased.
Happy 2nd birthday to our little #Easter buddy Billy. We are grateful always to the nurses and doctors at @CedarsSinai & @ChildrensLA who saved his life and all of you who prayed & sent positive thoughts our way. #HappyEaster — Jimmy Kimmel
Gene is a professor at Tulane University in Health Policy & Management and is program director for the MD/MPH and Graduate Certificate Leadership Programs. George is a medical student at Mayo Clinic Alix School of Medicine and is enveloped in the intersection of biomimicry, human-centered care, and architecture. Both Gene and George are members of the Care Collaboratory. Adapted from a piece written on October 15, 2017.
