How are you really? I’ve had ups and downs.
I’m grateful to everyone who was so supportive of last week’s post. Like all physicians, I’m a driven overachiever. It can be our superpower, but also our Achilles’ heel. My internal drive to set the bar high and to work hard has opened many doors for me. It’s also the source of some of my greatest suffering. I’ve been enjoying being coached with the Internal Family Systems (IFS) model, and it’s been quite revealing. I’ve discovered that this inner-achiever is a part of me who will do anything he can to try and help me, but he’s got some major blind spots. He can’t see the whole picture on his own — that sometimes this perfectionist drive is toxic. What’s more, he usually acts up when the most vulnerable parts of me seem threatened to him. There’s no easy fix for “achiever’s disease”, but helping this part of me feel seen and getting to know him has felt like such a relief. I feel lucky to have others who have gone before me to share about things like IFS. If you haven’t heard of it, it’s worth checking out. Exploring IFS is absolutely a contributor to my personal wellbeing. I’m a work in progress, mind you.
This brings me to my first update: following through on becoming a wellbeing-first organization.
This is easier said than done. I have no delusions that we will get this right from the beginning. What I am sure about is that this is the right commitment as our top priority. I’m still working my way through “The 4 Disciplines of Execution (4DX)”. I feel great about getting clarity on what’s wildly important for Medicine Forward to focus our energy on. What’s next is identifying the outcome we are shooting for that tells us we are winning, and identifying lead and lag metrics that help us get there. We also need a visible scorecard and a cadence of accountability. Add a little survey fatigue and the fact that this is an all-volunteer project to the mix, and this becomes quite a worthy challenge.
The good news is that I know how you eat an elephant. One. Bite. At. A. Time.
I am excited to keep digging into this project. It’s incredibly meaningful to me. As I said before, we will come across some hard choices along the way. We may need to cancel meetings or simplify our actions, even throw things overboard. I believe we must lead by example with this group. For me that’s integrity. For me this is everything.
Lastly, I’m attending a webinar shared by Sue Hingle next week that I’m really excited about. It’s a free event hosted by the Kern National Network called, “Human Flourishing 2030: Flourishing in Healthcare Spaces”. I think we need more events like this, and I hope you consider joining me. Thank you, Sue!
Prior auth update
This has been an exciting week in our work to disrupt prior auth. I must begin by doubling down on our BOLD VISION: zero friction from prior auth for patients and physicians by 2025. I’ve been running it by others, and we agree that this goal is clear, motivating, and difficult. I will be thinking a lot about the 4DX process for this as well. Similar to wellbeing, we’re going to need to identify lead and lag measures, design the right scorecard, and keep a cadence of accountability.
CVS was not winning hearts this week. They threw an extravagant private party with singer John Legend while profiting from care denials. In the context of UnitedHealth’s $5 billion quarterly profit, no one feels sorry for insurance for getting called out.
Our group has discussed the importance of bringing in insurance to the prior auth conversation as a major stakeholder. I think this is the right thing to do. I also can’t be a part of letting them off the hook. There are absolutely good people that work within insurance companies, but that doesn’t mean they are not responsible for doing better. I believe that all of us that are employed by healthcare corporations must take ownership of participating in a broken system that causes harm (That’s why my Twitter profile says I’m an accomplice in a broken healthcare system. I am.). Many of us are part of it, and that’s a tough pill to swallow. But, the sooner we stop worrying about being nice and start acknowledging we contribute to the problem, the faster we can move toward fixing it. That’s what we want, isn’t it?
Our next panel with ACP is coming together. Right now it looks like it will be in early October. The idea is to show that the voice of grassroots physicians can have a significant impact. We are looking at helping get the Senior’s Timely Access to Care Act passed through the Senate as our action. If you feel that this bill is too weak, you are not alone. But, I do think we can leverage it as part of our bigger goal of zero friction from prior auth by 2025. We can raise our voices to hold people’s feet to the fire and demand better. We and our patients deserve nothing less.
Stay tuned for updates to our website and Twitter account that reflect this bold vision.
Sustaining this organization with funding
This is the final wildly important goal (WIG) we’ve identified for Medicine Forward. It’s also the one I have the least idea how we’re going to solve. We will be using the 4DX method on this as well. I’m playing with a lead measure of spending one hour of focused time every week learning and strategizing about funding. I do a co-working session with one of my coaches weekly, and this has been a good time to work on this. I’ve been loving the book “Connecting to Change the World”. Today I connected with one of the authors (Peter Plastrik), and these were his ideas for funding for us to consider:
1) Membership dues. Your website says $5 for members. If that's correct, it's not enough. I don't know how many members you have but it would seem that 3-4 years into the effort, it's reasonable to ask members and prospective members to put a little more skin in the game. $50 a year might not scare off too many people and would increase this source of revenue, plus set the cultural expectation that financially supporting the network is a norm.
2) Health care philanthropy. Maybe pitching the diversity of the membership and that you are meeting needs unmet elsewhere in the profession would help you raise some $ from philanthropies already interested in the health of health care. Although this could involve a lot of "cold calls" on funders (which I hate), you could ask the network members who they know with influence in health care philanthropy and start with those people.
3) Health care HR professionals. If anyone ought to be interested in the industry in your work, it's the folks who are supposed to be stewards of employees and who increasingly need to recruit, select and train new hires. Perhaps you could develop several projects with HR professionals that they would fund and that would benefit your members; when budgeting for this work include overhead for the network so the work generates some revenue beyond the project.
Thank you, Peter! What do you think about his ideas?
That’s enough updates for today. There’s always more that can be written. But alas, I’ve already written a lot. It’s time to go play with my son and cook dinner — more parts of my own wellbeing.
You may be wondering what “55 weeks and 6 days” means from the top of the post. If you’ve read this far, I’ll give you the answer. It’s the amount of time left until I step down from leading Medicine Forward. My eye is on that countdown every time I write one of these posts to help me stay on track doing the best I can to serve our mission.
Onward!
Gabe