Fearlessly Looking Forward

This past summer marked my 25th anniversary working in healthcare. If you go back way before that, I think I really started when my mom, who was studying to be a nurse, brought me with her to her epidemiology class when I was 7 or when she voluntold me at 11 to work at a nursing home keeping the elderly company. People will attest that I have always been into healthcare, helping people, and medicine. I was a geek in high school and so I spent my lunches and summers doing homework and extra classes. I never took non-academic classes like driver's ed during school hours and I ended up with enough credits to graduate early. However, I decided to stay, do APs and get a medical assisting certificate so I could pay for college.

I started as a medical assistant in a small family practice in Utah. Back then, they let you do everything: give shots, draw blood, remove casts. It was a really fun way to enter healthcare. I kept medical assisting throughout college. I had the rare experiences of accidentally being in the right place at the right time and just paying attention. I was in the beta clinic for Epic. I remember everyone complaining about the EMR migration, way before it was cool to complain about EMR migrations. I worked in the same physician group, different time period, as Don Berwick, so ditto for quality measures. I was in an HMO-owned practice when the '90s backlash happened and almost sank the group. I saw how unhappy that way of practicing medicine made the physicians. That experience is actually what steered me into healthcare finance and leadership and away from medical school. Later, since I was in Massachusetts, we had some of the only surviving risk contracts from the backlash, but it kept us learning and moving forward in the two decades it took the rest of the country to come back.

Since then, I have had many amazing mentors, leaders, and opportunities. I have been incredibly lucky and also worked hard. But during this pandemic, during this election year, I made a choice to take a step back to reflect before I charge on. It was in those person-to-person encounters as a medical assistant. It was in those long, wise stories from our elderly. We need to get back to embracing the dignity of each other and our common family stories and worries. Healthcare is a person-to-person interaction, or family-based or village-based. It underpins everything from our abilities, happiness, and wealth. It's not Polyannaish to know that our strength is in our binding humanity and common mortality.

How are we going to change healthcare? How are we going to include as many people as possible? How are we really going to eliminate health disparities? How are we going to address all the social gaps that other OECD nations afford, more efficiently than our healthcare spend alone? I'm interested in your stories and thoughts. I have some thoughts too and I'll be sharing them throughout my sabbatical. However, conversation is always more interesting so thanks for sharing in advance. Let's be fearless together.