The change in leadership in Washington raises endless questions about its impact — on government, on society in general, and for healthcare policy and public health in particular.
It's clear we are on the cusp of a new and different era — an era of change and disruption that will be celebrated by many but viewed by others as depressing and stressful.
Those fearing the unknown with a sense of fatalism and negativity must face this reality: change often brings dysfunction and some chaos, but history reminds us that out of such turbulence comes opportunity — opportunities we must embrace.
For healthcare leaders, now is the opportune time to reaffirm our belief in protecting the essence of public health. We should never compromise that mission. But we should also be open-minded enough to support new policies and decisions that have the potential to improve public health and the way we do business.
Major change often gives birth to new, positive ideas that force us out of our comfort zones. The key is not to panic. Afterall, we survived the chaos of COVID-19 by abandoning our conventional playbook, being resourceful and adapting to life-threatening demands that challenged our operations unlike any time in our history.
Following are some suggestions for an agenda health leaders should consider as we confront the challenges of this new era:
1. Maintain a positive attitude.
A positive attitude resonates with staff and co-workers, and signals that we will get through whatever difficulties confront us. As healthcare professionals, we deal with the unknown on a daily basis. Emergency medicine professionals, for instance, never know what patients will come through the door next. Again, let's not forget our pandemic experience. Those who handled it best did so because of a winning, optimistic and resilient attitude. Every decade brings changes in policy direction and potential disruption. We have survived previous changes before — and we will do so again.
2. Tell our positive story.
Remarkable accomplishments occur in our facilities each day — in hospitals, ambulatory settings and in patients' homes. We prevent illness, treat disease, improve health, extend life and bring new life into the world. We discover new treatments, educate the future workforce and help unite families. These successes are often overlooked and underappreciated.
It's important to remind people of the dramatic accomplishments achieved over the past half-century. Just think of the remarkable progress we've made in reducing heart- and cancer-related deaths, and preserving mobility through advances in orthopedics. What we do today was unimaginable years ago. It's an incredibly positive story that demands constant telling, which is why we at Northwell Health opened our doors to filmmakers who have produced such docuseries as Netflix's "Lenox Hill" and "Emergency NYC," and HBO Max's "One South: Portrait of a Psych Unit," as well as the COVID-19 documentary "First Wave," now available on Hulu.
The skills, humanity, compassion and resilience that come through in these real-life stories should make us all proud to be in the healthcare profession. As we enter this period of uncertainty, we must continue to promote the positive narrative that defines our industry and navigate the months and years ahead with confidence.
3. Be a conveyor of truth.
As professionals, we have an obligation not to be vengeful or obstructionists, but to challenge unproven ideas and falsehoods that endanger public health. For example, vaccines have eradicated devastating diseases like polio and smallpox and significantly reduced the risk for other contagious diseases such as measles, pneumonia, tetanus and hepatitis. To gauge the benefits, we need to look no further than the resounding success of the COVID-19 vaccine, which prevented millions of additional deaths and hospitalizations. At Northwell, we had the privilege of immunizing the first American against the virus on Dec. 14, 2020.
We must never waver from our responsibility to preserve credibility and trust in evidence-based science. Scientific discoveries and their resulting treatments have had profound, positive benefits in increasing the lifespan of people worldwide. We must not be afraid to denounce skeptics who promote misinformation and stoke public fears.
4. Be supportive of new opportunities.
Change is inevitable and, as mentioned earlier, we should be open to new ideas that emerge during periods of disruption. For example, we should fully support public awareness and educational campaigns advocating healthy lifestyles — many of us already do. Similarly, we should be advocates for a thorough review of how food in this country is grown and produced. Americans are sold food loaded with too much sugar, salt and artificial ingredients, contributing to the obesity crisis and increasing the risk of other serious health conditions. Health systems must also be proactive in addressing food insecurity in their communities and enhancing the quality of food they serve patients and employees — to that end, Northwell's food service operations are now led by Michelin-star chefs.
Another area of opportunity is regulatory reform — the focus of the incoming administration and an issue raised by many of us in healthcare over the years. Not all regulations are bad, but many have become overly prescriptive, impeding our efficiency and creativity. Our ability to respond effectively during the COVID crisis was made possible by the relaxation and waiver of many regulations, allowing for innovation and flexibility. Now could be a rare chance to crystallize our position on the constraints we would like relaxed and be proactive in making it happen.
5. Defend access to care.
It's probable that efforts will be renewed to repeal or revamp the Affordable Care Act. It's difficult to believe how this could be accomplished without jeopardizing protections for patients or decreasing coverage. It's important to remember that the ACA has succeeded in reducing the number of uninsured Americans by nearly half: from 48 million in 2010 to about 25 million today. It's also worth noting that the ACA is viewed favorably by more than 60% of the public.
We must also reaffirm our belief — and do it strongly — that medical decisions on reproductive health should rest with individual patients, their families and their physicians and not be polluted by political ideology. Similarly, we must continue to campaign vigorously against coverage denials by insurance company personnel who have no direct contact with patients, yet often override the guidance of physicians.
I am also concerned about another public health issue that will be deprioritized by the new administration — gun violence prevention. Sadly, the White House Office of Gun Violence Prevention established in 2023 by the Biden administration will undoubtedly be dismantled, raising concerns about the future of federal funding and policy initiatives.
As healthcare executives, we see the consequences of gun violence daily in our trauma centers and in our emergency departments. I applaud the health leaders who have joined together as members of the National CEO Council on Gun Violence Prevention and Safety. We must accelerate our advocacy. The fact that guns are the leading cause of death for children and adolescents is a national disgrace and embarrassment.
6. Values matter.
The decline of respect and civility in society is clear to most observers. It's even more obvious in the toxicity of our public discourse. We must begin to respect those with differing points of view rather than demeaning their character and intelligence. Now more than ever, we as healthcare leaders need to promote the values of decency, respect, integrity, honesty and trust. We must be positive role models who embrace a sense of unity, togetherness and community — not anger and resentment.
This is an interesting time for all leaders. Such periods are often labeled "VUCA" — volatile, uncertain, complex and ambiguous. At some point in our careers, we've all had to confront these circumstances before.
The key is to be optimistic, resilient and continuously give oxygen to hope. Most importantly, we must do everything we can to strengthen trust in a public health system in which we should all take pride.
While the majority of Americans may have viewed the presidential election as a mandate for change, I doubt they are eager to embrace policy changes that jeopardize our health.
Michael J. Dowling is president and CEO of Northwell Health, New York's largest healthcare provider and private employer.