Healthcare Needs Some #GoodTrouble

By Kim Bellard July 22, 2020

As hopefully most of you know, Rep. John Lewis, civil right icon and longtime member of Congress, died this past Friday. Rep. Lewis was often described the “conscience of Congress” — perhaps a low bar in today’s Congress but important nonetheless — for his unwavering commitment to social justice.

Rep. Lewis must have been heartened by the fact that, in 2020, plenty of people are, indeed, making noise and getting into good trouble, necessary trouble over issues that he cared deeply about, like Black Lives Matter and voting rights. There are others who are better able to write about those people and that trouble. So I’d like to talk about his call to action with respect to healthcare.

If you are working today in healthcare — especially in the United States — or, for that matter, someone getting healthcare or having a loved one get it, then you should be making some noise and getting into good trouble, because our healthcare system most definitely makes it necessary.

Every day, too many of us suffer in the healthcare system, ranging from waits to indignities to critical mistakes, and some face financial ruin due to the care — whether good or bad. Most of us suffer in silence, or only complain to our friends and family. We don’t see a lot of mass protests about the pitiful state of our healthcare system, and I have to wonder why.

We have to stop being so passive.

For those of you working in healthcare, here are the first two things I’d urge you to get into good trouble about:

•         Stop doing stupid stuff
•         Do simple better

The first admonition comes from a movement developed by Melinda Ashton, MD at Hawaii Pacific Health. She started asking front-line workers to identify things that were “poorly designed, unnecessary, or just plain stupid,” and — not surprisingly — there turned out to be a lot.

The second comes from advice that Dan Gingiss gives about improving customer experience. Our healthcare system is the world’s largest Rube Goldberg machine, complicated beyond understanding and with much of that complexity not achieving intended goals.

Yet we continue to add complexity, layering new technologies onto old, inserting new layers and new types of intermediaries, all of which adds costs. Even things that aren’t inherently stupid are usually more complicated than is absolutely essential.

Before we make things even more complicated, we should focusing on making the simple things better. Who is getting into good trouble about that?

If the leadership at your healthcare organization doesn’t resemble the workers in it, or, equally important, the people receiving care from it, then you should be making noise. That’s worth getting into good trouble about. That’s necessary trouble.

Or take prices. As expensive as our healthcare system is, we’ve known for a long time that our problem isn’t getting too many healthcare service as it is the prices we pay for them. If you’re working in a healthcare organization that charges the people without health insurance much more, you should be making noise. If your organization is also suing those patients to collect the resulting debts, you should be getting into good trouble to try to stop it.

And, of course, if you are working in a healthcare organization where you see patients getting services they don’t actually need, or, worse yet, delivering substandard care, then you really should be making noise and getting into good trouble. That is definitely necessary trouble.

But it’s not only those working in healthcare. If you or your loved one is receiving care, you should be making noise when you aren’t treated with respect, or when you don’t get the information you need.

We can’t be afraid to make some noise about healthcare. We must be willing to make good trouble about the many, deep, and pervasive problems in our healthcare system. If that isn’t necessary trouble, I don’t know what is.

This post is an abridged version of the original posting in Medium. Please follow Kim on Medium and on Twitter (@kimbbellard)