U.S. Healthcare

Why hasn’t american healthcare system advanced at the pace USA desire?

From prestigious government positions to leadership roles in pharmaceuticals and health plans, experience spans various sectors. Yet, despite our rapid scientific advancements, the core system of healthcare delivery remains flawed.

The Struggle for Better Healthcare

Over the last two decades, numerous initiatives aimed to elevate U.S. healthcare. From research papers and grand proposals to world-renowned start-ups driven by the urge to revolutionize the system. But, when you evaluate the results, especially cost vs. outcomes, it’s evident that we fall behind compared to our peers. Several prevailing theories attempt to explain this stagnation:

  1. “How we pay for care has incentivized quantity over quality.”
  2. “Our lack of universal coverage has ballooned healthcare costs.”
  3. “Our fragmented information systems have isolated crucial data.”
  4. “Antitrust enforcement failures have led to monopolies, resulting in high costs.”
  5. “Information on improvements isn’t disseminated efficiently, causing patchy implementation.”

Though it’s tempting to dream of sweeping reforms and tech giants as saviors, the past tells a different story. Tech interventions have come and gone. Start-ups have mostly under-delivered. And policy reforms? They’ve been a mixed bag. So, maybe it’s time we realize: we are the solution we’ve been waiting for.

Physicians at the Forefront of Change

What if the true agents of change have been among us all along? Physicians, instead of viewing themselves as mere components, must embrace their pivotal role. They ought to:

  • Challenge the status quo.
  • Advocate passionately for their patients.
  • Become what philosopher Michael Waltzer called “embedded critics,” reforming the system from within.

Yes, it might feel lonely initially. But remember, every movement starts with a single voice. And soon, that voice can become a chorus for change.

Taking Charge and Breaking Boundaries

Historically, physicians have distanced themselves from healthcare administration and finance. But this detachment has its consequences. Non-clinical individuals have set performance metrics, defined drug formularies, and established treatment protocols. It’s high time physicians reclaim their roles, not just as clinicians but also as leaders and decision-makers in the broader healthcare ecosystem.

U.S. Healthcare

Accelerating Change

For impactful transformation, we must re-evaluate our pace. Clinical decisions are often immediate, yet outside the clinical setting, progress slows. We get trapped in bureaucratic cycles, prolonging implementation timelines. We’ve seen rapid adaptations, like during the COVID-19 crisis, proving swift large-scale change is possible. But, as we’ve seen firsthand, scaling up solutions requires more than just courage; it demands recognizing the everyday crises and addressing them urgently.

Guild vs. Profession: Where Have We Gone Wrong?

To maintain our credibility, we must advocate for things that aren’t in our best interest but that are in the best interests of the system or our patients, is a strong notion that underlines the dilemma many professionals face.

Looking at hospital mission statements, most of them revolve around providing competent services, but what about preventive healthcare or eliminating the need for most services altogether? The difference between functioning as a guild, which focuses on self-perpetuation, and a profession, bound by a skill set and ethical standards, is evident. We’ve seen instances where physician leaders prioritize personal or economic interests over patients.

However, this doesn’t mean constant self-sacrifice. We need to balance our interests with the greater good. Ethical leadership is at the core, and where we have sacrificed that credibility for short-term parochial interests—we have eroded trust.

Time and Engagement: Rethinking Roles

It’s common for professionals to feel swamped. With research, clinical duties, administration, family, and personal lives, where does one find the time for additional tasks?

It’s about engagement and showing up differently. Some might feel their institutions don’t appreciate or welcome their engagement. The key is to display that such engagement enriches decision-making quality. Changing times require passion, pace, and commitment. The current state of affairs, our “broken status quo,” didn’t evolve on its own.

Leadership is crucial; if we don’t step up, who will?

U.S. Healthcare

The Real Answer: Better Leadership

When pondering the question of what is needed to improve healthcare, the answers have evolved over time. While previously the emphasis was on better policies, financial incentives, or technology, the real answer now seems to be leadership. Policies like the HITECH Act and the ACA, or even value-based care, have all shown mixed results.

The real challenge is leadership. Some might chuckle at this, thinking of it as a naive solution. However, the system is a product of decisions, and the change should start from within. A few determined individuals can genuinely make a difference. Leadership, as believed:

“Is the act of sometimes sacrificing one’s own personal or institutional interest to advance the greater good.”

As the healthcare sector evolves, we need individuals who can step into these change-leading roles.


Transforming U.S. healthcare isn’t just about ideation; it’s about the swift and ethical execution of those ideas. As we move forward, we must remember the urgency of our mission and the lives that depend on it. Only then can we truly hope for a healthcare system that matches our aspirations.

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