Writer’s Block ..

Or maybe I should call it "Reider's block?" ..

Despite 15 years of blogging – this time, I've written and re-written a post so many times I can't count them.  So here's one to get me started.   

I had dinner last night with a former colleague who has had a long track record of success in government, health care, and education.  He’s getting close to retirement, and we talked about what has driven him – what he sees in himself as a leader, and why some people seem to find success so consistently, while others do not.

His goal after retirement is to teach in community colleges.  A community college grad himself – he reflected that these schools are special places that help others succeed.  Period.  The faculty are not arm-wrestling for status or grandeur. Students often have had other careers, or had less-than-stellar high school performance.  

He is a noble guy – with altruistic goals – and I think that this demeanor is what’s helped him succeed throughout is career.  I observed that his interest in teaching community college students aligns perfectly with how he’s approached every other job:  to help others succeed.  It’s not about himself or his own personal achievements.

This demeanor is uncommon.  But it’s certainly aligned with how I’ve tried to be throughout my career as well.  Success as a physician wasn’t ever measured by my income, or the number of patients I saw in a day – it was measured by my patients' success.  I served them.  Period.  To help them reach their own personal goals of health and happiness.

And then – at some point fairly late in my career – I realized that this approach – helping others succeed without judgment – without invoking MY agenda – was the same set of attributes that would align with success in other domains.

Fast forward to January 2015.  My dad has been in the hospital and I’ve once again witnessed the dysfunction of our care delivery system from the other side of the stethoscope.  It’s a sobering reminder.  The culture of health care that I witnessed in Boston (at the “best “ hospital in the world)  remains disconnected, distracted, and aligned on the wrong incentives:  

  • Revenue.  Fee-for-service models push care providers to maximize charges rather than care quality, patient experience, or best outcomes.
  • Recognition.  Smart, assertive heroes who do more, and write more papers and get more national or international recognition are perceived to be "better" physicians than folks who listen, share decisions with patients, and really focus on the right stuff.

Despite many efforts to change the way we pay for care, educate our physicians, or create stage 4 cultures - so far, it's not working.

But we can't stop trying.

And so my next chapter will be focused on a few guiding principles:

  • Work with great people who want to do what's best for others – to really add value to the world in a way that will empower others to find health and happiness.
  • Facilitate new cultural norms in health care that focus on shared decisions, collaboration, transparency, and compassion.
  • Avoid people and organizations who want to be "rock stars" and succeed for the sake of success – either in status or revenue or power.