Calming fears, alleviating suffering, enhancing and saving lives—this is what motivates doctors virtually every single day. When the structure and culture in which physicians work are well aligned, being a doctor is a most rewarding job. But something has gone wrong in the physician world, and it is urgent that we fix it.
Fundamental flaws in the US health care system make it more difficult and less rewarding than ever to be a doctor. The convergence of a complex amalgam of forces prevents primary care and specialty physicians from doing what they most want to do: Put their patients first at every step in the care process every time. Barriers include regulation, bureaucracy, the liability burden, reduced reimbursements, and much more. Physicians must accept the responsibility for guiding our nation toward a better health care delivery system, but the pathway forward—amidst jarring changes in our health care system—is not always clear.
In The Doctor Crisis, Dr. Jack Cochran, executive director of The Permanente Federation, and author Charles Kenney show how we can improve health care on a grassroots level, regardless of political policy disputes, by improving conditions for physicians and asking them to take on broader accountability; by calling on physicians to be effective leaders as well as excellent clinicians. The authors clarify the necessary steps required to enable physicians to focus on patient care and offer concrete ideas for establishing systems that place patients' needs above all else. Cochran and Kenney make a compelling case that fixing the doctor crisis is a prerequisite to achieving access to quality and affordable health care throughout the United States.
Cochran, executive director of the Permanente Federation, and former Boston Globe editor Kenney (Transforming Health Care) argue that while health care reform talk may be loudest among politicians in Washington, doctors have a pivotal role to play in improving medical "access, quality and affordability" by solving the "crisis" of burned out and pessimist members in their own ranks. The authors point out examples of potential solutions, using the Oct. 9, 2001 separation of conjoined twins Lexi and Sydney Stark as an illustration of "American medicine at its best." Cochran used his leadership at Kaiser Permanente in Colorado to lay out a new "mission" for the medical field: to support primary physicians' careers, better the "patient care experience," and streamline the care process. At the heart of the transformation is what Cochran calls the "Learning Coalition": "physicians as healer-leader-partner" looking for "best practices" and applying them at their hospitals and offices. The authors also address issues of liability burdens, transparency in healthcare, payment reform, and bringing health care to the workplace and schools. They cheerlead for a nation that supports its doctors "so they can do their best for patients," and for physicians to set the stage for real health care change.