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  • Writer's pictureA D Ackerman

We Will Heal Our Healthcare System from the Inside Out

That is my aspirational goal.

Yes, as outrageous as it may seem, that is my goal.

How, you may ask, am I planning to accomplish this gargantuan mission?

The answer is simple: By coaching one person (physician, nurse, clinician, leader), one team, or one organization at a time.

Right. So it will take a million years, and I don't have that kind of time.

You are correct. No one does. And our system certainly doesn't.

You don't want to hear any more about the problem of burnout among our physicians and other healthcare providers. At least I don't think you do, but please tell me if I am wrong. You see, I know that burnout is a big problem in our healthcare system, and you know it too. It has been getting worse, and it threatens our system to the very core. When the burnout rate is high, patients get less care, physicians, nurses, and other clinicians become emotionally detached, lose energy, and don't care anymore. They may become clinically depressed, and they lose interest in things they used to enjoy. Life becomes dull. And now, data show that more than half of all healthcare workers are burned out.

Their purpose is no longer clear.

Our healthcare organizations have noticed this trend, and many have tried to help. The problem is, I believe, that they are treating the wrong problem. They treat the symptoms (burned-out physicians, clinicians, and providers) rather than the disease itself (the root causes of burnout).

So what are the root causes of burnout? And what can we do about them?

The root causes are both individual and organizational (or systemic) in nature. And thus far, most of the attention has been placed on treating the individual. People are urged to develop mindfulness practices, cultivate outside hobbies, engage in health-promoting activities and diets, or get therapy. They are told to "develop resilience," as if that is something one can do on command. The worst part of all this is that people feel like something must be wrong with them because they have ended up being burned out. But how can it be that over half of our providers have something wrong with them that is causing this problem? No, I believe the reactions people are having are to be expected due to the systemic nature of the problem.

As I see it, the systemic issues include:

  1. Being overworked so that the physician or other clinician has less time to spend with each patient, causing them to feel like their role is increasingly less important to each patient's outcome. Many of my clients report feeling like they work on an "assembly line." Loss of physician (or other provider/clinician) autonomy, as more and more rules are devised by both government and private insurance companies in order for the practice to receive reimbursement. (Oh, and I should mention that rules are often different for different specific insurers, even for the same patient complaint or disease).

  2. The employer (practice or organization) focuses on "patient satisfaction" scores rather than valuing genuine ongoing relationships between physicians and patients.

  3. There is a reliance upon computerized data rather than conversation when gathering information during patient appointments, especially those with chronic diseases. This relates directly to #1 above. Less time with each patient contributes to this.

  4. The NUMBER ONE issue I see among my clients who are physicians and those who are leading healthcare organizations is a sense of powerlessness to make change, associated with a fear of retaliation by the organization that employs them if they speak up.

These issues can not be fixed through mindfulness practices, taking more "me" time, getting more exercise, eating better, or finding new hobbies. Our organizations must find a way to focus on the people caring for the patients. Once that happens, there is no limit to what we can achieve.

So, what can we do?

Here's the neat part of what I see. Coaching helps people develop intrinsic awareness of their power. Coaching encourages individuals to take the wheel and point their lives in a direction consistent with their values. Working with a coach, the physician, nurse, other provider, leader, or team can see what needs to be done and find the courage to do it.

You see, I don't know what the answers are, and I don't need to know (I do have some thoughts on the matter, but those are almost immaterial). Still, if each individual is enabled to see clearly, and can feel empowered to take action to create the most value for the entire healthcare system as well as for each person involved, then surely we will see a system that produces value for our healthcare workers, our patients, our organizations, and the entire system. And the elegant part of this vision is that the value created will depend on value for and about the individual and the overall system. Each person can achieve the best quality of life for themselves as they produce the best quality of care for their patients and the organization.

Helping ourselves to see clearly and to think clearly is the place to start. Defining the attributes of an excellent healthcare system is essential to know where we are headed. When we also consider the characteristics of a good life for the healthcare providers and the overall system, we will know what to do. As more and more individuals become empowered in this way, the entire system will change, and we will no longer have to choose between what is good for us and what is suitable for the system.

It is all a matter of the creation of value, which will require:

  1. Creativity to see what's good, and what could be better,

  2. Curiosity to learn how we can do better, and

  3. Courage to take a stand and work toward the optimal creation of value

The process starts by asking ourselves this question:

What choice can I make, and what action can I take, in this moment, to create the greatest net value?


Thanks for reading. I value your time and am honored you chose to spend the last few minutes reading this post. I hope it provided value for you. If so, I would appreciate it if you would share it with someone who might also find it of value.

I would love to hear from you. Please come find me on Twitter or LinkedIn. Or send me an email at

To add more value to your life, ask yourself this question every day: What choice can I make, and what action can I take in this moment to create the greatest net value? Then take the free VQ (value quotient) assessment to start your journey with Axiogenics and learn how to consistently play your "A" game.


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