Where Physicians and Disruption Should Meet (05:45)

“There is something special, even sacred, about taking care of a person who is sick, and I think that as long as we are able to express ourselves in a relatively selfless manner, it makes it difficult to have our arguments assailed,” says Marc Harrison.

Harrison encourages all health care professionals to reconnect with patients by walking in their shoes. He tells the story of how as a resident, he refused to see a mother who had showed up late for her pediatric clinic. But his mentor not only insisted that he see the patient, but that he also conduct a home visit and then return to the clinic the same way she had arrived — on a bus with two transfers and two screaming children.

“Let me tell you, it gives you compassion for another human being, and it makes me really mad when I hear people talk in a dismissive fashion about poor people and their lack of desire to take good care of themselves,” Harrison says.

We need to own the patient relationship, adds Kenneth Paulus — not in a paternalistic sense, but in the sense that health care professionals should connect with their patients before someone else does. The patient relationship is “up for grabs right now,” according to Paulus. He cites Amazon’s disruption and asks, “Who’s going to disrupt health care?”

“It could be any number of potential forces,” Paulus says. “If we clearly decide to own that patient relationship, and not just in the current day but for their entire lives, and build it on trust and make that the central theme of what we’re all about, then all of the noise with Washington ultimately will play out and will be OK. We will win in that — whatever model they cook up — if we own the patient relationship.”

Gary Kaplan agrees. “If we don’t take advantage of the opportunity to lead, it will be the disruptors, it will be the entrepreneurs and profiteers,” he says. “We need entrepreneurs, we need disruption, but [we also need] physicians and caring professionals partnering with patients and their families.” He adds, “It is a privilege that patients allow us at the most intimate, personal times in their lives. And we can harness that energy and we can be sure that the answers are the right ones long term.”

Owning the patient relationship is important, but you could own it working for somebody else if you’re not careful, warns Harrison. “So what we’re going to do is, we’re going to evolve this amazing health system with all the right values so that we can actually use our backbone right now, and then we can be the disruptor. If you wait for other people to disrupt, you’re done.”

It’s one thing to be a disruptor, adds Kaplan. “The challenge is, how do we spread that more broadly to become the focus of the health care system? It starts probably even before medical school.”

“Keeping those core values strong,” says Harrison. “Everything can change around the model as long as we’re continuing to be dedicated to helping people stay healthy.”

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

This panel discussion clip originally appeared in NEJM Catalyst on October 6, 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