Want to Change Healthcare? Change the Rules

If doctors and their patients want to change the Sick Care system and create a health and wellness system that is effective, they need to take a different tack.

Doctors are manning the barricades, fighting against what they think is a deterioration of the doctor-patient relationship due to heavy handed regulation and third party interference. They paint legislators, payers, lawyers, and regulators as the enemy and are advocating for a guerilla war, fought in the examining rooms, to win the hearts and minds of patients in an effort to support the cause.

Innovation drives change. However, it derives from the rules. Rules create and facilitate ecosystems. Ecosystems drive business models that, if successful, sustain innovation.

Some doctors and their professional societies spend lots of money trying to change the rules. Some spend almost nothing. The result of the internecine lobbying is division that plays into the hands of those seeking to create public policy consistent with their ambitions and political persuasions.

If doctors and their patients want to change the Sick Care system and create a health and wellness system that is effective, they need to take a different tack.

Rules are either created proactively to drive change or reactively to respond to change. Most of the time (particularly in the US, the land of the "don't waste a crisis"), they are the latter instead of the former. Few are visionary enough to go where the puck will be or have the courage to battle the status quo.

The battle will be won in the hearing rooms of Congress, not the examining rooms of doctors. Physician entrepreneurs live in a world of rules. Understanding how healthcare policy is shaped, influenced and enacted is part of the core curriculum. Ignoring that is like doing surgery without knowing the anatomy and physiology.