Daily Meditations on Healthcare

One year ago this week, Doctors for America launched Progress Notes, the blog devoted to doctors discussing problems and solutions in access, affordability, and quality of health care in America.

We have had posts on detailed economic questions, and posts on stories about patients we wish we could have served better. There are medical students blogging here, as well as very experienced physicians in specialties across the spectrum. We even have some blogging MD’s who write professionally.

As I reflect on a year of blogging, I have three reactions. First, doctors want to talk about the problems we face as health providers, and our non-physician peers want to hear our candid insights. Second, we have a lot to talk about, and the answers are not all there. Third, and probably most importantly, writing is an essential tool for considering complex problems and evaluating possible solutions.

On the need for us to speak to our experiences, and the audience for that expression, anyone following the blog can attest to the fact that response to our writings has been enthusiastic. Our posts have been re-posted by other blogs and groups, like www.kevinmd.com, and Families USA. My non-physician communities often thank me for sharing my blog on social media. I’ve even had members of my local community ask for my opinion on controversial medical/political topics after reading my blog pieces.

Doctors must continue to publicly address the difficult questions of why, how, and how much, health to provide for Americans.

The answers to tough questions about problems like cost control, universal coverage, and adequate prevention, continue to elude us. We are approaching some of the first major milestones in the Affordable Care Act, as most states are struggling to collect revenue for existing projects. Even private insurers are scrambling to be “early adopters” as the provision of health in America transforms.

At a wedding last week, I was told by a high-school classmate, also a physician, that he supported the health care reform movement, but he doesn’t understand how we are going to cover all the new patients entering the Medicare system. I have to confess, I don’t have a cut and dry answer to that one.

Progress Notes, the Doctors for America Blog,  is one small, but significant part of the quest for answers to tough questions on cost control, prevention, and access.

Finally, my personal reflection on blogging about reforming our health sytem, is that it forces me to think about health policy and health access problems, every day. In his book, BetterDr. Atul Gawande suggests four habits for continuously improving as a physician. One that has stuck with me is “write something.” When you write, you are forced to structure and clarify your thoughts. Writing asks that you focus on a topic, and then express your insights as clearly as possible. This means that when my high-school classmate asks me about cost control measures in the ACA, I come back to the question when it’s time to write my blog. Or, when a Blue Cross Blue shield representative approaches me about participating in their “Patient Centered Medical Home” pilot, I think about it in a larger context than just my own practice.

That daily meditation on how to make our health system better is central to the importance of Progress Notes.

All of us should be sharing that daily meditation, putting our shoulder to the wheel, and pushing in the same direction, to forge a safer, cheaper, more accessible health system for all Americans.