Working in the healthcare industry is not for the faint of heart. No matter what role you play, your responsibility is to support the needs of people who are often in their most vulnerable state. If your job is not dedicated to this mission, in one way or another, please quit now. Because, while healthcare is a business in the US, our work has arguably the greatest impact on the lives of everyday Americans.
Having recently reached a decade of dedication to this all-important mission, I took some time to reflect on what skills have helped me succeed thus far. 10 years in healthcare is small compared to the multitude of people who have dedicated their lives to this admirable cause, but it certainly feels like dog years to me.
Physicians, nurses, care managers, social workers, hospital leaders, insurance executives, technologists, and many more all play a massive role in shaping the quality of care delivered to patients. However, the personal and professional objectives of each of these different groups are often conflicting.
If you can’t negotiate or persuade people to do what is best for the system (often misaligned with their personal goals), then I believe making an impact is nearly impossible. You may have the best idea in the world, but it means nothing if you can’t get the right people on board. The best arrow in the negotiation quiver is to really understand life from the perspective of your stakeholders. Get in their shoes and figure out what is important to them. Only then can you really come to an effective solution.
Enthusiasm for Change
Every single year, there is a new regulation being implemented to try and fix the failures of our current healthcare system. Every single year, there is a new technology that promises to make care delivery easier. Every single year, there will be a high-priority organizational fire that you need to put out. If you don’t thrive in a rapidly changing environment, then your own doctor will put you on blood pressure medication before you turn 30.
We all have started projects, only to be interrupted by the next bright, shiny innovation with outsized promises (cough ICD10 cough). There is absolutely no way to keep up, and that is okay. Identify the changes that are important, attack, and iterate. You are a part of the slowest moving startup in the world.
Passion for Nuance
“No one knew healthcare could be this hard.” While our pundit-in-chief says some nonsensical things daily (hourly? minutely?), he at least got the second part of this statement right. Understanding healthcare is HARD. Just learning the role of every major player is difficult, let alone thinking about how changes in one part of the industry will affect another.
However, it is literally your job to think long and hard about how your decisions impact others. There are tons of health economists out there who do a lot of this thinking for you. So, if you aren’t pondering what will happen when HHS abolishes PBM rebates, read about it. Approach every conversation like you don’t understand the concepts being discussed because the nuance in healthcare is overbearing. I learn hundreds of new things every single day - and I don’t expect this to change for the rest of my career.
I said it earlier, but here it is again. If your work is not positively impacting the life of a patient (directly or indirectly), quit your job now. Everything we do in healthcare needs to be focused on driving better health for those we treat and support. If it is not, you are legitimately wasting your time and theirs.
With that said, your focus on the patient needs to go beyond just staying in business so that you can treat more people. Spend time with patients from all walks of life and understand what they are experiencing. Talk to your grandmother or grandfather, mom or dad who have likely had to deal with health issues in the past. Think about what a good experience looks like if you were to need treatment. Remember that healthcare in the office is just a small part of someone’s everyday life. Until you know what they go through beyond their time with the doctor, then you can’t design a system that will meet their needs.
I see things every day that make me want to throw a chair at the wall. Pharmaceutical companies jacking up prices on monopolist drugs because they can. Providers refusing to embrace value based care because it is so different from their status quo. Payers denying coverage based on pre-existing conditions or legal nuance. This list could be 100 pages long (and would likely send you into a deep, unwavering depression).
You need the resilience to witness these challenges and bounce back. You need the resilience to debate those who resist the positive change you are trying to espouse. You need the resilience to not give up when you fail miserably because some new regulation disrupted your current project. This is true in pretty much all careers, but it is especially a requirement in healthcare.
To me, there is no better purpose in the world than knowing that my work is ultimately helping people live healthier, happier lives. These skills were crucial to my survival of this career choice thus far, and they will certainly be necessary going forward. A healthcare career can be an unforgiving bastard, but it also greatly rewards those who endure its challenges.