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As physician leaders, our opinions matter. Whether the audience is our family at the holiday dinner table, team members at a meeting, the audience at a presentation, or a media reporter, people want to know what we think and are willing to share when the topic revolves around healthcare. As we embark on another new year, a common question asked in many of these circles is, "What are the most important challenges facing healthcare?"
Table 1 lists and categorizes common responses to this question that I am sure we have all used. The list has validity; all of us confront these healthcare challenges each day with our teams and patients. The list is durable, meaning that the same topics show up year after year. This alone suggests that perhaps the challenges are so large they will require a significant multi-year effort and collaboration to achieve progress.
The pandemic has changed the context of care. While the topics are similar to those in pre-pandemic times, we lost valuable time and ground in our fight against these healthcare challenges because the pandemic required us to reprioritize our work during those years. The pandemic also may have created a completely new set of emerging issues that will require our ongoing attention as we attempt to recover from the chaos of those years.
To get a better understanding of how this list of challenges resonates with patients and their significant others, I performed a "field test" among five patients and their families to get a better understanding of the healthcare concerns that they faced. Although the observations I share are purely anecdotal, they may provide some important things to consider the next time the question is asked of us.
All of these patients were older than 65, all had a dedicated spouse participating in their healthcare journey, all were college educated, and all were insured by Medicare and alternate insurance. In some cases, these patients were Medicare Advantage members; others had supplemental private insurance. Most importantly, all of the patients had a diagnosis of a Stage 4 malignancy with a limited life expectancy, which highlights the degree of complexity that they were dealing with in their lives and healthcare decision-making.
It also helped to frame the conversation, because these...