Navigating leadership challenges in health care

Mike Merrill ©Mike Merrill

The global crisis that was the COVID-19 pandemic revealed that the health care system — in the United States and around the world — faces several challenges that prevent its efficient operation. Perhaps the biggest obstacle is the worsening relationship between patients and their health care providers. Leaders in the health care space are struggling to restore this relationship between provider and patient so that they can provide optimal care.

A shortage of workers spurred by poor working conditions

Today, the health care system faces an urgent shortage of health care workers, with reports showing that there could be a shortage of 122,000 physicians in the United States by 2032. This staggering statistic reveals that the health care system is woefully unable to meet the demands of our population and that those in need of medical assistance are often unable to receive the level and quality of care they need.

Many have cited poor working conditions as the leading cause of this worker shortage in the health care sector. Although working in health care has always been (and will always be) challenging, today’s health care workers are experiencing even more tribulations than usual. In a self-perpetuating cycle, the shortage forces many workers to work long hours, often including mandatory overtime. The COVID-19 pandemic has also highlighted how front-line health care workers expose themselves to potential hazards in their daily duties.

Although the worker experience may not seem like a crucial factor in the patient experience, remember that front-line health care workers are those who interact with the patients. The attitudes of health care workers have a direct effect on patient satisfaction. Thus, health care leaders must be sensitive to the smooth functioning of front-line operations.

Why patients often don’t trust the health care system

Simultaneously, the public’s trust in the health care system is beginning to erode. According to an Edelman report from 2022, 48% of respondents in the United States reported that the health care system’s response to the COVID-19 pandemic “decreased their confidence that the health care system is equipped to handle major health crises.” With the physician shortage contributing even more to the system’s inability to cope, this level of trust could be in danger of decreasing even further.

Some of the fundamental flaws in the health care system that obstruct the public’s trust in health care providers include:

Cost of care: Financial concern is one of the main obstacles to the public’s confidence in the health care system — often even causing individuals not to seek the medical help they need. The complexity of the insurance system and high costs can cause patients to feel an inherent distrust towards their providers, whether warranted or not. Many patients worry about being overcharged and receiving unnecessary treatments, creating financial hardships from medical expenses that could have been avoided.

Communication struggles: The other key factor in the inefficiency of the medical system is poor communication. This ties into the physician shortage, as many patients may find themselves unable to receive care — or waiting a long time to be seen — because there are not enough doctors to treat them. If patients cannot receive care or are getting inadequate telehealth care due to no in-person visit, they could be mistrustful of their providers.

Lack of transparency: Similarly, many patients face a lack of transparency from their medical providers — especially in an institutional setting. For example, in an emergency room situation, care may be so urgent that there is no time to determine what procedures are covered by insurance and jump through the hoops of the approval process. If a treatment prescribed by the medical provider is not covered under the patient’s insurance, the patient could be left with thousands of dollars or more in medical bills.

Addressing the shortcomings of the US health care system

The first step health care leaders should take to improve the system is enhancing communication and transparency. By providing patients with a clearer insight into medical decision-making, costs, and treatment options, patients will have a better expectation of their treatment.

Patient safety should also be made a priority for all health care organizations — if it isn’t already. Establishing programs such as robust training initiatives to prevent medical errors or systems in place to report mistakes can help reassure patients that they are consistently receiving high-quality care.

Improving access and affordability of essential health care services can further aid health care institutions in serving their patients better. On a broad scale, this may entail insurance reform and addressing disparities in access to care. However, individual institutions also have the power to implement meaningful change on a smaller scale by implementing innovative and flexible payment models that better meet patients’ needs and abilities.

Finally, health care organizations should strive to foster collaboration and partnership with other entities involved in patient care, including researchers, lawmakers, community organizations, insurance providers, and — most importantly — front-line workers. Everyone should be unified under the mission of providing great patient care, and this requires a rich sense of collaboration with leaders in other areas of the health care system.

Many business leaders in the health care industry get so distracted by the behind-the-scenes of running a business in the medical field that they lose sight of the operational challenges they face. Although it can be frightening to be exposed to the front line of health care, good health care leaders must witness the work going on first-hand to improve working conditions.

Remember, the ultimate goal of the health care industry is not to make money but to provide patient care. Achieving this goal requires health care leaders to invest not only in their patients but also in their front-line workers who will be providing the care. This is how health care providers can restore their relationship with patients.

Mike Merrill, MD, is a physician executive, author, and educator with a multifaceted career. He has completed residencies in internal medicine and preventive medicine, with professional roles at a state psychiatric hospital and a maximum-security jail. He has also worked as a hospitalist for a decade and served as the Chief Medical Officer of a rural hospital, overseeing its transformation into a high-quality teaching institution. He is the chief medical officer at Brook Health and co-author of, “Leadership Is Overcoming the Natural: 52 Maxims To Move Beyond Instinct”