We’re Not as Good as We Can Be (02:29)

Is the pace of change in health care going too fast, or too slow? Is it productive?

“If we’re honest with ourselves, we aren’t as good as we can be,” says Gary Kaplan. “I’m very proud of American medicine, I’m a product of it, but I think we can be better.” He points to quality, safety, workplace morale, cost, and other dimensions to improve.

“Frankly, we’re not changing fast enough,” he adds. “It doesn’t always feel that way at any given moment, and solving any given problem on any day of the week, but we need much more urgency. We need to say we’ve got to fix these problems, and we’ve got to do them in ways that leave the health care healthy enough to move forward.”

“It’s immature whether we think it’s too fast or not, because it’s happening,” says Marc Harrison. “Ask all the folks who used to work at Blockbuster how they like change. You better get with it.”

Harrison asks how many people in the room used Amazon in the last 2 weeks, and nearly everyone raises their hands. Half of those hands remain when he asks about using Amazon a year ago. What about 5 years ago? Only a few hands stay in the air.

“It’s here, and by the way, the ‘good old days’ were terrible,” says Harrison, noting that he did in-house calls every third night for 20 years.

Kaplan agrees. When some of his colleagues complain about change, he asks, “What’s so good about the status quo? Or about the old ways?”

“They inevitably are stuck, because it wasn’t so good then.”

From the NEJM Catalyst event Physicians Leading | Leading Physicians at Intermountain Healthcare, July 12, 2017.

More From Leadership
UCLPartners Leadership Competency Framework

Building a New Kind of Leader for an Era of Cooperation

Moving from competition to collaboration requires different leaders, and a different way to evaluate leadership potential.

How to Have a High-Performing Employed Medical Group Without a Hospital Subsidy

It’s a generally accepted view that all hospital-employed physician groups are constitutionally incapable of operating without financial support from the hospital. PinnacleHealth Medical Group found that commonsense tactics can eliminate the need for hospitals to expend precious resources to support employed physicians.

Wanted: Talented, Energetic, Creative People to Work on Difficult, Boring Problems. No Perks.

Let’s admit the inconvenient, boring truth.

Physician Coaching: Clinicians Helping Clinicians on the Things That Matter Most

A physician coach reflects on who gets better, what works, and how to create a learning culture.

Jessica Dudley and Namita Mohta head shots

Professional Fulfillment: Where We Want to Be

How the CMO of Brigham and Women’s Physicians Organization combats burnout at her institution and empowers physicians with leadership skills.

Texas Medical Center Houston Methodist Checklist to Maintain Operations During Hurricane Harvey and Future Flood Events

Lessons in Leadership: How the World’s Largest Medical Center Braced for Hurricane Harvey

Due to learnings from previous hurricanes, five success factors kept the Texas Medical Center operational during one of the worst natural disasters in recent U.S. history.

Lessons in Leadership: How the BayCare Health System Withstood Hurricane Irma

BayCare’s extensive disaster preparations were crucial in weathering the storm.

The VA Is a Quality Leader, Contrary to Many People’s Assumptions

A defense of the Veterans Health Administration, from its former Acting Under Secretary.

Medicine Is Not Manufacturing

Treating medicine as just another business is to deny its soul, the essential element that has given patients comfort and relief for thousands of years.

Lessons in Leadership: Transformative Collaboration Across the Care Continuum

Collaborative relationships across settings are critical to optimizing care, yet difficult to achieve.


A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »


Economic Investment and the Journey to…

Early successes suggest that value-based purchasing programs can both transform employer-based health care and have…

Leading Transformation

167 Articles

We’re Not as Good as We…

Is the pace of change in health care going too fast, or too slow?

Leading Teams

118 Articles

The Importance of Leadership to Organizational…

Effective leadership is built on a solid foundation consisting of a clear mission, a vision…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now