Guest post by Motient co-founder Dr. Richard Watson
Recently, our neighbor’s house burned down. Just two weeks ago. Ironically, I woke up early that day to smoke a brisket. As I went out to check the smoker, I heard the popping of wood burning. I looked up to see the faint glow just a block away. I ran up the hill to find six-foot flames at the back of the house.
Thankfully, my neighbor’s family managed to escape. Together they sat safely on the curb in their pajamas as they watched all of their earthly possessions turn to ash. It’s a sight I will never forget.
Few events are as personally devastating as a fire. And on that day, in the early morning, a small light fixture chose to malfunction. And it set off a series of events that pushed the reset button on an entire family.
When I eventually spoke to firefighters, they described it as a “defensive” fire. When they rolled up and saw the house completely engulfed in flames, they quickly assessed that it was already a total loss and moved to protect people and property around the perimeter.
Shedding What’s Not Working in Healthcare
Maybe I’m inclined to see everything as an analogy for COVID-19, but this one seems to be a natural fit. From the beginning of the pandemic, it seemed that our “house of healthcare” was on fire. This conflagration felt like a set-up in many ways. For example, we were already too lean on people—even though healthcare workers are the lifeblood of healthcare itself. Plus, short supply of necessary resources, like medications, equipment, and supplies. Many organizations felt forced into the corner by ever-shrinking reimbursements and expanding layers of expense unrelated to patient care.
All too quickly, health care workers and ecosystems became defensive. That is because we were all just trying to protect the perimeter and do the best we could with the resources we had. In the meantime, the families — those directly affected by the infection — also sat on the curb in disbelief, no different than the family that lost their home in the fire. They have suffered much, and they will never be the same.
Recently, there was a crowd of passersby at the burn site of our neighbor’s home. They comprised of neighbors, people out on their morning runs, or families walking their dogs.
Many pontificated about how the fire might have started. Did trucks get there quickly enough? Why wasn’t our 911 dispatch more effective? Others in the neighborhood slept right through it. Neighbors only a few houses away seemed insulated by the blaring sirens and dangerous flames, blissfully unaware of the unfolding tragedy.
Once again, I draw upon the similarities of our COVID-19 experience. While just a few have been in the midst of the fire, passersby are content to offer advice and point out gaps in the system. Most, especially now, are sleeping through the fire, feeling somewhat secure that the most severe stages are over, and life can go on. All the while, the house smolders on.
Rebuilding the Future of Healthcare
Fast forward a year from now. The charred roof and frame will be long gone. Builders will be on-site with fresh lumber. The sound of hammers and saws will have long replaced the crackling of wood and the breaking of glass. Discussions about carpet and tile, new appliances, moving bathrooms, and enlarging the kitchen will take center stage.
As for healthcare, we will also have a chance to rebuild. Our collective understanding of the people, processes, and resources that are necessary for cost-efficient, high-quality healthcare is stronger than ever.
I wonder, will we take the time to look at the floor plan of what we rebuild? Will we move the walls of reimbursement? And enlarge the communication and networking to connect our previously siloed infrastructure? Or will we slap up some cheap edifice to the old ways of thinking, and bring wheelbarrows filled with charred processes back into the healthcare house?
Anyone who has lost their home will recognize the emotional tug-of-war between rebuilding a site that reflects the previous structure versus starting fresh and rebuilding for the future. There is understandable excitement about returning to the old house we remember. Maybe even with a few upgrades.
At some point, the homeowner might voice a thought about a very meaningful personal item, once situated in a box somewhere in the home. And then their voice trails off with the memory and a sobering realization that this item is forever gone. The heart and soul of our lives are often grounded by memories tied to these material things.
My hope is that healthcare has not lost its heart and soul during these last two years. I choose to believe that the process of dealing with constant unknowns, coupled with loss and grief, hasn’t wrung out the last drop of compassion from those who are driven to take care of people in need.
We have a big job ahead. We can look forward to the chance of stripping away truckloads of bureaucracy that accumulated while we applied bandages to our current system. Together, we must create a new floor plan. We must choose our builder wisely. The lumber must be carefully selected, and we must stand firm: We will not bring the charred processes of the past back into our new healthcare house. The people in healthcare are up for the challenge. Together, we will build it back even better than before.