We all hear it these days — “Healthcare is undergoing profound change, and we need to be ready.” This phrase has been circulating for the better part of our careers. I graduated from medical school in 1981 and remember hearing then about the needed changes for healthcare. I also remember commenting to a senior faculty person while I was a surgery resident about how I thought his generation had it better than our coming generation. Interestingly, his immediate response was, “Actually, Peter, I think the generation before mine had it perfectly.” Over the years there have been numerous other examples for me as well.
Physicians care deeply about patients and people in general. We proudly wear our altruism and idealism on our sleeves. And, yes, at times, the grass can be greener elsewhere. But in our drive toward greener grass, we continually seek ways to better manage or control our environments. This is often an inherent component of physician personalities. Sometimes we succeed in our efforts with managing the circumstances, while at other times we become frustrated and even demoralized. Nonetheless, doing what is best for patients remains a core belief and an essential beacon of stability in healthcare. From my perspective, students and trainees of today continue with that same sense of value — perhaps even stronger than prior generations.
The paradox is this, however: human beings are human beings, and our core physiological, biochemical, and biological processes do not change that drastically over relatively short periods of time. Yes, the general health and welfare of people gradually change, and the evolution of disease states also gradually change over time. But none of those changes are rapid, and it takes decades, generations, or even centuries for the changes to become evident. Human beings are, after all, human beings.
So where is all the change coming from? A short list includes:
Improved basic understanding of our biology and physiology;
Development of better pharmaceuticals and medical devices;
An appreciation that focusing on preventive health may be a preferred approach to managing disease states;
Recognition that supporting sciences such as epidemiology and biostatistics can refine our understandings; and
The realization that implementing a continuum-of-care approach will provide improved health and better patient outcomes.
The potentially more frustrating arenas of change for physicians, however, are not those related to the historical approaches for improving the science of medicine. They are changes imposed on the delivery of care because of:
The increasing presence of political and policy engagement with healthcare;
Escalating regulatory and oversight burdens;
Expanding sets of inexact measures and flawed reporting efforts;
Routine shifting of risk management and expense burdens;
Ongoing uncertainty with the legal environment and future approaches within healthcare; and
Poorly aligned financial models that routinely confuse all participants in the industry.
Again, this is just a short list. While the evolution of human beings and disease states are slower, the exciting pace of change with science and technology continues to rapidly gain momentum at unprecedented levels. But it is the speed of change, the courses of change in healthcare delivery models, and the rapidly shifting policy, financial, or legal reform approaches that I hear about from fellow physicians.
The frustration with these changes is difficult to manage because these are areas in which physicians are not routinely provided the background education or opportunity to easily gain further knowledge and understanding.
When they are not able to understand, physicians can become discouraged by change. There is no inherent resistance to change itself, but more to the difficulty in knowing how to adapt and adjust to change when the circumstances or the environment are uncertain and unpredictable. In reality, physicians often are proud of their ability to flex, change, and innovate.
We are indeed in a state of perpetual change for the industry. But this is a critically important period in healthcare, because it is being recognized and appreciated that physician leadership is pivotal for driving successful change in healthcare at all levels. I remain impressed with how the physician workforce has become more engaged with learning how to adjust and participate constructively with these changes. Physicians are making significant impacts across a host of environments. Positive change is happening as a result of physician engagement.
Excerpted from Inspiring Growth and Leadership in Medical Careers: Transform Healthcare as a Physician Leader (American Association for Physician Leadership, 2024).