Rise Up: It’s Time for the Healthcare System to Be Brave

First of a five part exploration

I was listening to a podcast recently about the astonishing pace of AI development. New models dropping weekly. Companies raising billions. Technology reshaping industries seemingly overnight. And then it struck me: we don’t have this in healthcare.

Like everything, transformation seems to come to healthcare late. AI can write poetry, compose music, and generate photorealistic video, but I still can’t easily find my patient’s chart from another provider. Everything remains disconnected. Smart people are building incredible tools, yet we’re still stuck doing things largely the same way we did two decades ago.

It’s time to be brave.

From Digitizing to Humanizing

Healthcare has spent twenty years digitizing care. EMRs replaced paper. Prescriptions went electronic. Labs became accessible online. This was necessary work. But the real challenge now is to humanize all of that technology.

Physicians are tired. Not all of us are burned out – that’s a big leap – but we are genuinely exhausted. We feel helpless sometimes, like no one is in our corner. Not because our egos demand support, but because this matters to patient care.

My daughter severely fractured and dislocated her ankle recently. We spent all night in emergency in a major teaching hospital. After six hours sitting in a chair in the waiting room, she finally saw the orthopedic resident. They reduced the fracture and dislocation, placed her in a cast, said she needed surgery within two weeks and told her that the hospital would call to schedule that important procedure.  It’s now seven weeks, and still no call to schedule her OR. She has received two bills for the cast. Good news: she has two physician parents. We called a colleague, used our network, got her into fracture clinic, and her surgery was done in 5 days at our local hospital.   But what about patients who don’t have that privilege? What about the families calling repeatedly, getting lost in the system, wondering if anyone is paying attention?

Is anyone paying attention???

This is the massive cognitive load and significant moral injury facing clinicians daily. Calling other providers and almost begging for a patient to be seen. Chasing referrals. Not knowing where our patients are, what’s happening to them, or what data exists about their care. We’re not asking for much. We just need things to work better.

AI Is an Accelerant, Not a Destination

The hype around AI is enormous. But here’s the reality: even companies that have gone all-in on AI aren’t yet seeing the productivity gains, cost reductions, or return on investment they expected. The AI companies themselves aren’t making money anywhere near their burn rate. The trickle-down effect of these technologies into healthcare, particularly in publicly funded systems, is slow.

But there is real promise. AI scribes are an obvious example. The business case is clear: no physician office should be without one. When I use my scribe, something remarkable happens.  When with a patient I rarely look at my computer anymore. I can lean in.  I look at the patient the entire visit. I talk them through my exam.  This dramatically changes my patient’s perception of the encounter. It changes how I think, process, and arrive at conclusions. I become a better doctor because I can finally pay attention again.

I used to teach family medicine residents. One of my learners, in her first week, spent fifteen minutes with a patient while I watched. When she came out, I asked how it felt. “Discombobulated” she said.  “Nervous.”  I told her what I’d observed: in fifteen minutes, she had looked at the computer for thirteen and a half of them. The patient got ninety seconds of eye contact. Next visit I said “turn your screen off.  Talk to your patient. Listen.  Then come back and tell me how it feels.”  She finished in twelve minutes instead of fifteen. She got way more useful information. She had some great differentials.  She felt more on top of the problem. And she reported exactly what I expected:  “it felt great.”

That’s the point. AI shouldn’t replace us. It should free us to be more human. Honestly, I don’t want more “AI” at this point, I just want more “I”:  intelligent software that knows my patterns, anticipates my needs, and does repetitive tasks automatically. It can be artificial or just programmed in. I don’t care as long as it works.  AI is pattern recognition at scale. It’s an accelerant, not a destination.

The question is: where do we apply the gas?

Workflow Is Everything

I sit on national committees discussing interoperability. Over and over, we hear the same thing: the main problem we need to address is horrible digital workflows. If we don’t think about interoperability from a workflow perspective, we haven’t actually helped anyone.

Workflow means understanding what clinicians do every day. How they view their computers. What gets in the way. Even one extra keystroke seems like nothing, but multiply it by thousands across a day, and it’s crushing. My EMR hasn’t substantively changed in years. It basically the same product I bought in 2007. We aren’t seeing progress where it matters most.

Innovation must be rooted in clinical reality. Tools that don’t fit into how care actually happens will fail, no matter how sophisticated the technology. Whoever builds the bridge between clinicians and transformative technology, whoever understands both the clinical journey and the technical possibilities, will lead healthcare’s future.

Show Up, Speak Up, Ante Up

Leadership in healthcare transformation doesn’t require being elected or standing on a stage. You can lead quietly, under the radar, and be extraordinarily effective, if what you care about is the endpoint, not the credit.

Three principles guide this kind of leadership. First, show up: be present everywhere these conversations are happening. Second, speak up: ask questions, share insights, challenge assumptions. Third, ante up: do the work.

Don’t just talk about transformation, build it.

Healthcare needs people willing to be honest brokers. Intermediaries who can translate between clinicians, governments, vendors, and agencies. People who understand that policy is being shaped right now, and that where there’s a vacuum, something will fill it. Better that it be filled by people who understand the clinical reality.

The Call to Courage

Doctors are expertly trained at detecting when something doesn’t ring true. We see through spin in about five seconds. What we need from those driving healthcare transformation is honesty, speed, and relevance. Be honest about what works and what doesn’t. Move fast, by the time evaluations are published, we’re often past deployment. And stay grounded in the daily reality of clinical practice.

The technology exists. The opportunity is here. What’s missing is courage, the willingness to take smart risks, challenge the status quo, and insist that healthcare catch up to the world around it.

Our patients deserve it. Our clinicians need it. And frankly, the system can’t sustain itself otherwise.

It’s time to rise up.

Following in this exploration of  problems will be four pointed articles about solutions.  Complaining and identifying is not enough.  We are going to explore how to make things better sooner rather than later with ideas

1. For Governments
2. For our Associations, Colleges and Universities
3. For Clinicians
4. For Technology Vendors

Check back daily!