Opinion | Loving Sunday Night

My father worked for the federal government for over 30 years, ultimately at the top of his career serving as the director of the Community and Consumer Liaison Division of the Federal Aviation Administration.

He was a self-admitted policy wonk who enjoyed thinking about government rules and regulations, proudly considered himself a bureaucrat, and loved what he did.

He was the direct connection between the individuals and communities served by transportation systems of the federal government and the administrative machine that helped oversee them. Over the course of his career, he helped make airports more accessible to the disabled; addressed countless community concerns about pollution, access, and noise; and always felt like he was making a difference.

Once in my teens when we were driving somewhere, we were talking about his work and my future, and he told me something that has stuck with me for the rest of my life. He said, “When that alarm clock goes off in the morning, if you don’t open up your eyes and say, ‘Oh goody, I get to go to work today; I get to go do the job I have,’ then you’re in the wrong line of work, and it’s time to get out.” I think this is what we all strive for, what we all wish for, what we all hope for — the chance to do something that is satisfying, exciting, and makes a difference.

I love when my alarm clock goes off on Monday morning (although I also love the snooze button as much as the next person). Don’t get me wrong — I know that I’m going to be facing a lot of frustrations, dealing with so many of the things in our fractured healthcare system that I’ve written about in this column, but in the end, this job, this incredible blessing of a career that we all in healthcare have, is worth putting up with almost anything.

We get to take care of people. There’s nothing quite like it; it’s an honor and a privilege, but nonetheless, I do feel we have a responsibility to fight like hell to make sure that things are only going to be better for the next generation of doctors and other healthcare providers, as well as to create the best system we can envision and insist on for our patients.

So, when I look ahead at my schedule for Monday, I see a bunch of meetings in the morning, I have a number of items on my to-do list for projects that I need to get to, and then a pretty full schedule of patients through the rest of the day. I’m looking forward to it, and I don’t think there’s anything else I’d rather do.

But can we do better? Wouldn’t it be great to go to bed on Sunday night, and wake up on Monday morning, knowing that an ideal healthcare system is standing by ready to do everything it can to help us take care of our patients? Instead of the bloated administrative bureaucratic mess we have that spends far too much on imbalanced and inequitable care, wouldn’t it be great if every patient got the right care at the right time, and everybody working on the healthcare delivery side had all the tools and resources they needed to effectively carry this forward?

I know many of us are working on the weekends: finishing notes; answering emails and portal messages; writing patient lab result letters; reading up on our patients’ medical conditions; writing grants and academic articles; finishing research studies; and analyzing data. Come Monday morning, wouldn’t it be great to know that we had an amazing team of people who are there helping make all of these things happen as effortlessly as possible, to get the better results that we and our patients deserve?

We need to build efficient population health and patient navigator systems that can review, with the help of data from our electronic medical record, what our patients are missing, what they need, and what we can do to help make sure that all their healthcare issues are addressed. That everyone who wants a mammogram gets one, that everyone’s vaccines are up-to-date, and that their chronic medical conditions are optimized.

That the full force of the true patient-centered medical home care team is arrayed around our patients, from nursing education and follow-up to mental health resources and counselors and therapists, to community health workers, to access to healthy food, clean water, and safe exercise facilities. That our patients can always get in to see the specialists they need, can always afford the medicines we want them to have, and can always get — in a timely way and without interference — the imaging that we think they need. That smart systems are being designed out there to do pattern recognition on the data we collect, to help make sure that things don’t fall through the cracks.

The possibilities are endless, but the time has come for us to no longer accept what we have as good enough. I don’t think any of us need to sit through another PowerPoint presentation, Grand Rounds talk, or policy seminar that shows what percentage of our country’s GDP is spent on healthcare and how poor our health outcomes are compared to the rest of the world.

There are so many lessons to be learned from how others have done this, and there are so many voices here in our own country, in our own healthcare system, among policymakers and healthcare thinkers, that can lead us to a better place. We just have to have the strength and determination to no longer accept an unacceptable system, to demand that we as a single practitioner, a group practice, a hospital system, a neighborhood, a community, a state, and a nation, need to do things better. Then we will all be happy when that alarm starts buzzing early Monday morning.

Time to wake up.