The evolution of healthcare around the world is a subject that gets people talking. In particular, doctors and other healthcare movers and shakers are having important conversations about how to effect meaningful change that truly improves patients’ lives.
From first-hand accounts of the impact of social determinants of health (SDoH) to the importance of a team-based approach to care and one author’s take on our single greatest accomplishment over the past century, these presentations give us insight into the need for fundamental changes. These innovators are focused on seeing each patient as a whole person and considering all aspects of their lives in the way they’re treated and supported.
1—Dr. Mitchell Katz, “What the U.S. Healthcare System Assumes about You”
Assumptions are infamous for their role in creating awkward situations. But in healthcare, they can lead to reduced quality of life and poor outcomes when it comes to low-income patients. Dr. Mitchell Katz, President and Chief Executive Officer of NYC Health + Hospitals, shares what he’s seen first-hand through decades spent caring for disadvantaged patients in New York City, Los Angeles, and San Francisco.
Dr. Katz explains that because our healthcare system is built on a middle-class model, it fails to meet the needs of low-income patients in many ways. Assumptions such as having transportation and the ability to take off work, speak and read English, have a working phone, and access food and housing greatly impact care and can hinder many people from taking even basic steps toward better health. His remedy for these social determinants of health starts with meeting patients where they are and never making assumptions.
2—Dr. Wendy Ward, “The Future of Healthcare—Why Patients Should Care”
After navigating the short- and long-term ramifications of shoulder surgery, Wendy Ward, Ph.D., began to question whether receiving the defined standard of care is the same as getting the best care possible. A professor at the University of Arkansas for Medical Sciences, Dr. Ward notes that “whole people need whole, team-based care, which is the best care possible.”
Her theory is that patients want and need four basic things throughout their healthcare journey. One of these is having the positive, supportive experience of a team-based approach for well-rounded care. Although there are 100+ different kinds of healthcare professionals, no one person knows everything, but together, the members of a team can supply the necessary knowledge. Working as a collective with a common goal reduces medical errors, controls costs, and creates a far better experience for the patient, making it critical for the future of healthcare.
3—Dr. Rishi Manchanda, “What Makes Us Sick? Look Upstream”
This Talk has been around a while, but its relevance remains key. In fact, Dr. Manchanda, Founder, President, and CEO of HealthBegins, gave a similar (and hugely popular) presentation at Icario’s Healthcare Innovation conference in 2020. In this TED Talk, he recounts the story of a patient with chronic headaches, the cause of which couldn’t be determined by looking at her chart. But inquiring about the condition of her home unlocked the mystery.
Drawing upon his work with patients in South Central Los Angeles, Dr. Manchanda calls this using an upstream model. It’s the practice of enabling the entire healthcare workforce—from doctors and nurses to care managers, social workers, and other clinicians—to alter their approach and get to the root causes of conditions. It starts by asking questions about the context of patients’ lives to reveal the impact of social determinants of health.
These ‘upstreamists’ are growing in number and understand that living and working conditions impact our health even more than our genetic code. Dr. Manchanda discusses how mobilizing response and remediation can help connect patients to the resources they need to live healthier lives and move the country from ‘sick care’ to healthcare.
Bonus—Steven Johnson, “How Humanity Doubled Human Life Expectancy in a Century”
When thinking about the major successes of the past century, author Steven Johnson argues the most important accomplishment boils down to a single metric: life expectancy. A hundred years ago, people generally lived to their mid-30s. Today, the average is 70.
As Johnson investigates how we as a species have increased our longevity, he delivers interesting anecdotes about some of the milestones that got us here. Of note, he recalls the fascinating path of milk pasteurization in the U.S., which reveals that science and chemistry alone weren’t enough to bring about meaningful change to a dietary staple that once killed many children.
Johnson notes education and persuasion were key to convincing both the industry and consumers to support pasteurization, underscoring important parallels to the acceptance of clinical innovations today.
Johnson also speaks to the need for ongoing improvements, regulatory oversight, and guardrails to keep regulators from over-reach. He suggests that if the first great accomplishment was extending life, the second should be closing the gaps in healthcare and making those extra years healthier.