Messy Impossible Monday

I spent today with Mick Ebeling and his team from Not Impossible Labs at an intensive hosted by one of the professional orgs I belong to.

It wasn’t cheap to sign up and travel to Nashville for this, but having heard Mick speak before, I knew that it was something that would inspire me and test me to see if this really was a direction I could go—one where I tap into all of that frustration about the state of healthcare and channel it into change.

I said I was going to sit back and listen, and, honestly, I’m doing that more than I usually do—but my desire to really lean into this workshop had me pushing more than I planned.

What if healthcare wasn’t a business? What if access to healthcare education was accessible? What if we shrunk the pay gap between the highest-paid and lowest-paid employee? What if RVUs didn’t exist? What if we treated mind and body together? What if EDs were all federally funded and supported? What if state licensing boards were replaced with a national one? 

The list goes on and on. We have applied such constraints on ourselves that the ability to see what’s possible if our sole focus was on “what is healthcare?” and “how do we support health?” 

Perhaps I’m naive to think we can ever be an industry that pays a janitorial staff responsible for completing terminal cleans of hospital rooms after a discharge and is a huge reason for infection control successes even a fraction of what we pay someone who sits on the top floor or wields the most complicated surgery tools. 

Perhaps I’m naive to think one day insurance companies will again trust doctors to develop a plan of treatment that meets clinical best practice and the patient needs and preferences. 

Perhaps I’m naive to think that one day we’ll care less about how to code care and more about if our patient’s family has access to three meals a day.

Perhaps I’m naive to believe that healthcare can become mission-driven again, that humans will learn that medicine will never be perfect, can never fix all, and sometimes it’s not as easy as we may think. After all, we’ve created a world where patients expect more than most clinicians can really deliver, and clinicians are constrained by a system built around the fear of legalities because society has weaponized so much of it.

True innovation comes at a cost, one we may or may not realize. So we can accept the status quo of our healthcare system being fragmented, inaccessible, driven by profit margins—even if non-profit—and slowly dying on the vine as skilled professionals like doctors and nurses become harder and harder to recruit... Or... we can say enough is enough, giants of industry be damned, and toss that bowling ball down the lane and start knocking down those pins of "how we've always done things." Because if we TRULY decide to leave that mindset home, everything gets thrown to the wind and we start over.

Who's up for that challenge?