Tomorrow is Independence Day. Happy 4th of July! After an introductory paragraph, our Declaration of Independence begins like this: “We hold these truths to be self-evident, that all men are created equal , that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.--That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed.” We is the key work to me, and our American government gets its power from the consent of the governed. The idea that we are all in this together stands out to me. Now let’s talk about leadership and healthcare reform as it relates to this central idea of what it means to be an American.
There are two kinds of leaders and I have worked with and for both kinds. The first is the “strong man.” (Or woman) The strong man rules by dominance, threats, intimidation, and controlling other people. “I have all the answers. I know best. Only I can solve this. I don’t need your advice. Just do what I tell you and do your job.” They don’t look for input or advice from other people. They only look for loyalty to themselves and their agenda.
The other kind of leader is entirely different. They are responsible for the final decision, but they know what they know, and they know what they don’t know. That may be the most important quality of the effective leader. They know that they don’t know everything, and they depend on others to fill in the gaps. The best example of this approach is General George Marshall who was the architect of the allied victory in WWII and the Marshall Plan that rebuilt Europe after the war. He knew what he knew, and he knew what he didn’t know. He hated yes men. He depended on his staff to provide their real honest opinions. If he had any idea that someone was telling him what they thought he wanted to hear, he would fire them. “Principled criticism and dissent were hallmarks of outstanding organizations and Marshall believed they needed to be nurtured and encouraged rather than expelled. As an aide to General John J. Pershing for five years, Marshall discovered that Pershing appreciated honest criticism and had the extraordinary ability not to take an affront personally; rather, he used it to strengthen the issue or position at hand. This level of professionalism and two-way dialogue was a lasting trait that Marshall employed throughout the remainder of his service.” That is effective leadership.
The first kind of leader is always trouble. There are far too many of them in the American healthcare system. They are a barrier to healthcare reform. They already have all the answers. They think they are doing things as well as they can be done now, but they could not be more wrong. They are leading a system that costs four times as much as it should. It does not serve the people. It serves them—the CEOs, stockholders, and MBAs. I hated working for them. The worksite culture is toxic, and the organizations led by these people are never as successful as they could be. There are too many of them in healthcare. They don’t listen to anyone.
We need many more of the second type of leader in healthcare. The kind that constructs effective teams that can provide care that is designed for the good of patients rather than institutions. The best kind of medical leader creates an environment to facilitate the greatest success of every member of the team. All of the best health systems work that way. The Southcentral Foundation, Vestra, and German employer’s insurance are all owned and managed by the people they serve. That is medicine of, for, and by the people. Those are the organizations that deliver care that is truly patient-centered.
We. We at Health Direct Partners are a collaboration of the second type of healthcare leaders. We hold these truths to be self-evident. American healthcare is broken. All Americans are created equal. The best healthcare systems in the world derive their power from the consent and input of the people served. That means it is time for a healthcare revolution and our government of, for, and by the people just gave us the perfect tool to get there—The Consolidated Appropriations act. Most of you get your health insurance from your employer. This legislation requires your employer to make sure the health care you receive is effective and reasonably priced. Health Direct Partners exists to help your employer meet these requirements easily.
Everyone of you has a stake in the success of this revolution and that is exactly what we are talking about. Tweaking the current system will never work. Our system is truly broken, and drastic changes are required to serve you better. “Between the care we have, and the care that we could have, lies not just a gap, but a chasm!!!” You all can contribute. All revolutions require public understanding and support. Tell your friends about the new law. Tell them the law is on our side. Have them start reading these posts. We welcome your input. Let us know if your community or employer is interested in working with us. We must save ourselves. No one will do it for us!
Bill, you know this: without using objective quantitative physiological tools we developed, people are flying sightless to determine what’s safe and effective. Waiting for outcome data without these tools is not only dangerous but also costly. Let's not repeat the same failed policies of the unacceptable and corrupt late-stage-sickness-seeking-profiteering legacy 19th Century medicine.
I'm a nurse and couldn't agree more. Maybe things were broken before, but never before in my lifetime, has killing been 'legitimized'. The current silence and denial is staggering.
Thank you for your post.