The healthcare system has many flaws that have become more pronounced since the beginning of the COVID-19 pandemic.
Leaders not only struggle to navigate the growing complexity of the field, but try to maintain staff who are burnt out, keep operations running smoothly while cutting costs, all while trying to provide quality care to patients.
Becker's asked leaders, if they could instantly change one thing about the healthcare system, what would it be.
Note: Responses have been lightly edited for clarity and length.
Vi-Anne Antrum, DNP, RN. Chief Nursing Officer at Cone Health (Greensboro, N.C.): If I could wave a magic wand and instantly change one thing, it would be violence against healthcare workers. Our nurses, physicians, techs and other team members come to work every day to provide great patient care in some of the most difficult times in people's lives. They have families and loved ones that they help take care of at home after work. They faced years of fighting a global pandemic with some of the most politicized health practices I've ever seen, faced social unrest, asynchronous learning, some of the highest rates of mental health needs in history, and a vast array of public reactions from heroes to villains and landing somewhere in between today. They are good people trying to do good work for those they serve and are faced with being yelled at, kicked, spat on, maimed, injured and even killed in some cases. People deserve to come to work with the expectation of going home safe while they are working so hard to save people's lives!
Wesley Burks, MD. CEO of UNC Health and Dean of the UNC School of Medicine (Chapel Hill, N.C.): I would want to see us all focused on what I call "healthy-based care," an effort to keep patients healthy and out of the hospital. Every decision we make as providers should be based on whether it will make a patient healthier. It is a better way to care for patients. I believe it would go a long way to reduce provider burnout and connect us back to what brought us to medicine — the desire to help people stay or become healthy.
Thomas Corkery, DO. Chief Medical Officer at Canonsburg (Pa.) Hospital/Allegheny Health Network: I think reducing the administrative burden on physicians regarding electronic health records. Physicians have become data entry clerks and we spend more time in the records than with patients. It's difficult when the provider is working on the computer while talking to the patient but not really looking at the patient. There's only so much time in the day and it takes much longer to complete the patient encounter electronically than it used to when we dictated notes.
That face-to-face with the patient can't be lost in the practice of medicine. Interaction with your patient is most important.
Stephen Ferrara, DNP. President of the American Association of Nurse Practitioners: Provide patients with greater access to care by modernizing our healthcare system to ensure policies that govern practice accurately reflect who is providing care in communities across the country. We must focus on retiring barriers to practice that remain in the Medicare system and ensure states grant patients full and direct access to their chosen healthcare providers. These critically important policy steps can move our nation toward better health outcomes and higher quality of life for patients.
Doug Lawson, PhD. CEO of St. Luke's Health (Houston): I would take my magic wand and fix the health inequities that exist in our nation's healthcare system. Specifically, the socioeconomic inequities in access to care and the health disparities that persist in communities where poverty is endemic, but also in communities of color of any economic strata where cultural biases — whether they are implicit or unconscious beliefs — held by healthcare providers themselves can lead to much poorer care and outcomes, especially for Black, Hispanic and indigenous people.
Athena Minor, RN. Chief Nursing and Clinical Officer at Ohio County HealthCare (Hartford, Ky.): I would change agendas that are based on greed — both corporate and personal. There are good people and good organizations in healthcare who truly want to meet the needs of the population they serve. That is why many of us chose this profession; however, greed has driven a lot of healthcare decisions from a vast amount of healthcare entities and organizations. So much of what is wrong with our healthcare system today stems from a desire to accumulate more — more facilities, more market share, more profit. I understand that healthcare is a business and there needs to be a reasonable net profit in order to continue to provide services; a healthy profit margin is not the issue — it is what we sacrifice for profit and that there never seems to be enough. We need to get out of the healthcare business and get back to the business of healthcare!
Greed-based agendas have created the need for a virtual army of staff to fight for precertification and address denials from payers for the reasonable care of patients. Greed-based agendas have created a lack of true interoperability and constructed information silos within our technology solutions (compatible IT solutions aren't good business). These agendas have stripped away a great deal of our collegial collaboration and replaced it with industrial competition. We have seen fraud and deception for personal gain within our industry professionals and leadership. We have been held hostage by a workforce that knows they can hold out for the highest bidder. We have seen large healthcare organizations swallow up smaller independent organizations only to close much needed unprofitable services, supplying communities only with services that produce the most revenue.
Healthcare organizations need to expand based on need and not on greed. Continual growth for the sake of profit is a corporate agenda; growth to fill healthcare gaps is a caregiver's agenda.
Kirsten Riggs, BSN, RN. COO at UNC Health Rex (Raleigh, N.C.): If I could instantly change one thing in healthcare, it would be to ensure that every person has access to affordable, high-quality healthcare. This would involve addressing systemic issues such as disparities, the high cost of healthcare and the lack of access in certain areas. It would also involve ensuring that healthcare providers have the resources they need to provide the best possible care to their patients. Ultimately, this would lead to better health outcomes for everyone and a more equitable healthcare system.
Karan Singh, MD. Chief Medical Officer at San Gorgonio Memorial Hospital (Banning, Calif.): I think bridging the different incentives within healthcare together is my big thing. The system is really broken because the hospitals, physicians, pharmacies and medical device companies all have their own incentives. There's no conjoined thing about the patient or an incentive to focus on keeping patients healthy. Shifting our focus from treating acute illness to preventing disease can be our shared goal. Our current system doesn't make much sense in the long scheme and the shared goal to prevent disease can really drive the conversation. Being in the driver's seat of impact in healthcare change is really the key.
Airica Steed, Ed.D, RN. CEO at MetroHealth (Cleveland): The central challenge we face in healthcare today and the change we need most involves addressing the galling health inequities impacting our communities. This is why I am laser-focused on eradicating health disparities, not slowing them down or putting a dent in them, ending them. To do this, healthcare institutions must more directly address the social drivers of health, such as economic insecurity, food insecurity and housing insecurity, that have a key impact on a person's wellbeing and disproportionately impact underserved and minority communities. We must go outside the four walls of the hospital and into our communities, providing stronger neighborhood-centric care that is designed to build up the health and wealth of all communities we serve. This is the only way we can ensure everyone gets the high-quality healthcare they deserve.