By Randy Pilgrim, MD, FACEP, FAAFP
In health care today, our days are filled with concerns – patient care complexities, staffing shortages, throughput issues, and a myriad of other challenges. Fundamentally, as clinicians, we are deeply concerned about our ability to deliver high-quality care in a chaotic environment. The issues of the day (or night) occupy most of our time, energy, and efforts.
It takes a lot to face today’s realities. It takes even more to keep your chin up, stay positive, remain hopeful, let alone inspire genuine change. With all of today’s challenges, can we afford to care about tomorrow?
My own professional journey, including through COVID, presented many opportunities to disconnect from the stark realities of health care today. My passion for patient care has not faltered. But sometimes, the changes and challenges seem overwhelming. Change is needed at so many levels – in our departments, in our hospitals, in our health systems, and in health policy itself.
A mentor once said, “If you like things the way they are, stop caring, don’t change anything or both.” What he meant was that change doesn’t just happen. Those who desire something better can switch from being a victim to being an agent of change. It takes more than education, incisiveness, and far more than complaining. Further, he noted that my passion for excellence at the bedside easily translates to larger health care issues. The skills and tasks are different, but the passion is the same.
Maybe he was right. I spent years honing clinical skills, building good departments, and making the hospital a better place. Maybe there was more to do. In any case, I already knew the best antidote for discomfort is real action. It gets us unstuck and newly motivated, even if change takes a long time.
Effective advocacy can reduce unnecessary struggles, promote better care, and simplify care delivery. It does not solve all things. But it pushes them in the right direction.
As health care challenges deepen, widen, and become more prolonged, we need to exercise our advocacy muscles further and more effectively. In our environment today, a few things have become abundantly clear:
- If we are to continue our patient-centered mission, we MUST join our voices with others. Our collective voices must be heard. Failing that, observations and solutions will simply fade away, no matter how meritorious they may be. And we will continue to feel downtrodden, wondering if things will ever improve.
- The system must find a new balance – one that enables patients to get the care they need in a timely manner, one that enables clinicians to deliver care in a stable and workable environment and one that inspires confidence and satisfaction with our important work.
- Change won’t happen overnight. It will be laborious process. It involves reimagining much of what we currently have, even though it’s “standard.” We must become creative, utilizing the advanced tools we have. And we must always ensure that we anchor our work in the fundamental “humanness” of health care.
For almost three decades, we have advocated collaboratively, within our organization and across the health care industry as a whole, acting at local, regional, state, and federal levels. From physicians, NPs, PAs, nurses, and medical directors to revenue cycle specialists, operational leaders, and hospital executives – everyone has a role to play. Effective advocacy – the kind that produces meaningful solutions – arises from on-the-ground experiences and is effective if we collaborate with others who know what we mean. Our perspectives are the ones policymakers often lack. We have the knowledge and ability to impact our environment, identifying opportunities and enacting meaningful change for health care.
In 2022, we were integrally involved in many successes. Some were positive steps forward, and some prevented further losses. The Dr. Lorna Breen Health Care Provider Protection Act was enacted, creating a national 988 Suicide and Crisis Lifeline. Telehealth flexibilities were extended through 2024. Two court cases regarding the No Surprises Act resulted in favorable rulings for providers, preventing a further backslide in fair payment for clinical services. CMS established new network adequacy standards for commercial health plans and released No Surprises Act FAQs and Checklist of Payor Requirements in response to an uproar from the provider community. In just one year, we accomplished much. Yet there is more to do.
To do more, we need you. We need your continued feedback on what works and what doesn’t. In the hospital, in your communities, and with your health systems, we need your ideas, solutions, and especially, your voice. With all of that, we can advocate for a more effective health system, better outcomes, reduced administrative burdens, and a workable clinical environment. We need revenue cycle specialists to share opportunities for efficiency and fair reimbursement. We need operational leaders to suggest scalable solutions to ensure that our patients are clinically well-connected after they leave the hospital.
Our environment will not change overnight. Sometimes we will go backward before we go forward. But we must never lose sight of our commitments: patient care excellence, high-performing teams, innovation, and, above all, healing. These commitments will allow us to invest meaningfully “today” while enacting meaningful change for “tomorrow”. We owe that to our patients, our colleagues, and to the health care system itself. For me, it’s one of the greatest privileges of being a physician.
Thank you for all you do.