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.

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