3 surprising lessons U.S. medicine can learn from around the world

As a medical student, I chose Stanford for my residency to learn from Dr. Norman Shumway . A giant in cardiovascular surgery, Shumway was the first American doctor to perform a successful heart transplant.

But along my path toward becoming a cardiac surgeon, I rotated on the plastic and reconstructive surgery service, which included a week of operating in Mexico on children with cleft lips and palates.

On day one, I watched in awe as the team leader meticulously realigned the tissues of the lip, mouth, and nose of a three-month-old boy, leaving behind nothing but a faint scar—all in just 90 minutes.

By the time I returned, I had fallen in love with the specialty, changed my professional path and never looked back. I’ve since had the opportunity to volunteer on mission trips in more than a dozen countries. I took a two-decade pause on those surgical trips when I was selected as CEO at Kaiser Permanente, but last month, a mission trip to the Philippines reignited my passion for global surgery. It also provided three key lessons about American healthcare:

1. Without mission and purpose, medicine proves exhausting

Surgical trips are physically and emotionally demanding. Far from the sterilized corridors of American hospitals, you are plunged into environments where resources are scarce and the needs overwhelming. In remote towns and underdeveloped cities, you operate in tight spaces with erratic electricity and limited clean water. The days stretch long, with five to seven surgeries in a 12-hour day.

Each child you treat carries a story of hardship and hope, their families’ eyes filled with a mix of fear and optimism. And just as you start to tire from the heat and yearn for a good night’s sleep, another mother arrives. She has walked for two days through the mountains with a child in her arms, praying her baby can be added to the surgical schedule. There is no saying “no” to this. You immediately become reinvigorated.

Later that night, after the procedure, you carry the child to the recovery unit, and watch the mother take her baby into her arms. The silent language of her tears fills the room. It’s a moment of profound connection, a place where relief, fulfillment and happiness coexist.

You return to the United States not physically drained, but emotionally replenished.?Nearly every clinician who has participated in one feels the exact same way.

Today’s American healthcare system obscures the fundamental mission and purpose that motivates clinicians. Physicians currently find themselves ensnared in a web of administrative tasks and insurance disputes. For many doctors, this noble calling has become just a job.

To reinvigorate the profession and address the burnout crisis that affects more than 60% of clinicians , a renaissance of purpose is imperative.

To get there, we must pivot away from the transactional “fee for service” financial model that rewards doctors for the sheer quantity of services rendered. In its place: a reimbursement model led by clinicians who are paid based on the quality of clinical outcomes achieved.

Inherent in the privilege of healing is the duty to lead this transformation. Taking on that accountability—and eliminating the care restrictions that insurance companies impose—will rejuvenate, not further fatigue, healthcare professionals.?

2. American doctors are excellent but so are physicians around the globe

U.S. physicians believe that training outside the states is a second-rate education. It’s time to alter that perspective.

During my week in the Philippines, I had the pleasure of working alongside five local physicians, often at adjoining OR tables. They’d trained in residency and fellowship programs all around the world to maximize their expertise. And to a person, their results matched the quality of the leading pediatric hospitals in the United States.

U.S. doctors have access to the best facilities, machines and materials. But the competitive advantage of physicians in other nations is high volume. The best way to hone your skill is through repetition and experience. American surgeons lag their global colleagues in this area.

A few years ago, during a visit to India, I had the privilege of meeting with Dr. Devi Shetty , the country’s leading heart surgeon and a former physician to Mother Teresa. Dr. Shetty oversees a remarkable team at his Bangalore hospital, where the scale of operations is staggering. On the day of my visit, his teams performed 40 surgeries, including a heart transplant—a volume that far exceeds what is typical in most U.S. hospitals across an entire week. The quality of care was exceptional, matching the highest standards I’ve seen in the United States.

My encounters with Dr. Shetty’s practice in India and with physicians in the Philippines highlights a reciprocal learning opportunity for the American medical community. U.S. clinicians bring a wealth of knowledge that can greatly benefit doctors worldwide, yet there are equally rich lessons to learn from the experiences and practices of physicians abroad.

For example, instead of setting minimum surgical volume standards as in the U.S. today, patient outcomes would improve by setting benchmarks for superior performance. Combining high-volume surgical experience with advanced technological and facility resources will produce excellent clinical outcomes. American medicine’s future will benefit from embracing humility and being open to learning from our global colleagues.

3. U.S. resources are vast but access is still scarce

In countries like the Philippines and India, healthcare challenges are magnified by economic constraints. Despite governmental coverage, per capita healthcare spending remains low, at under $200 in the Philippines and just $60 in India. This financial reality forces difficult choices, leaving significant gaps between the healthcare needs of the population and the services available—and between the care provided to rich and poor patients.

Witnessing these disparities firsthand is a poignant reminder of the abundance the United States enjoys, with healthcare spending now exceeding $13,000 per American . And yet, despite our wealth as a nation, independent studies reveal that U.S. healthcare ranks last among a dozen wealthy nations and near the bottom of 38 OECD countries , behind Costa Rica, Estonia and South Korea in more than a dozen health measures.

Our nation has earned its distinction as home to the “most expensive and least effective” healthcare system in the developed world. This isn’t just because of our 30 million uninsured citizens (and tens of millions more who are underinsured). It’s the result of decades of underinvestment in primary care, inefficient hospital systems and exorbitant drug prices.

The challenge of transforming American healthcare is daunting, and it requires a willingness to embrace change and confront uncomfortable truths. Observing the efficiency and ingenuity of less affluent nations should inspire a reevaluation of our care-delivery practices and healthcare finances.

The biggest problem in our system is not a lack of money. It’s the deficit in leadership and innovation.

Volunteering on global missions offers invaluable perspectives that could catalyze change in the United States. By learning from countries that achieve remarkable outcomes with modest means, we can enhance clinical outcomes, reduce clinician burnout, and make quality healthcare accessible and affordable for all Americans.