Synopses & Reviews
Calming fears, alleviating suffering, enhancing and saving livesthis is what motivates doctors virtually every single day. When the structure and culture in which physicians work are well aligned, being a doctor is a most rewarding job. But something has gone wrong in the physician world, and it is urgent that we fix it.
Fundamental flaws in the US health care system make it more difficult and less rewarding than ever to be a doctor. The convergence of a complex amalgam of forces prevents primary care and specialty physicians from doing what they most want to do: Put their patients first at every step in the care process every time. Barriers include regulation, bureaucracy, the liability burden, reduced reimbursements, and much more. Physicians must accept the responsibility for guiding our nation toward a better health care delivery system, but the pathway forwardamidst jarring changes in our health care systemis not always clear.
In The Doctor Crisis, Dr. Jack Cochran, executive director of The Permanente Federation, and author Charles Kenney show how we can improve health care on a grassroots level, regardless of political policy disputes, by improving conditions for physicians and asking them to take on broader accountability; by calling on physicians to be effective leaders as well as excellent clinicians. The authors clarify the necessary steps required to enable physicians to focus on patient care and offer concrete ideas for establishing systems that place patients needs above all else. Cochran and Kenney make a compelling case that fixing the doctor crisis is a prerequisite to achieving access to quality and affordable health care throughout the United States.
"Rare is the book that defines and successfully presents solutions to a problem as complex as that faced by most practicing physicians today. Cochran and Kenneys ability to present their ideas so clearly and cogently makes this an especially valuable book. Even though it specifically addresses change within the health care industry...it will doubtless serve as a very useful guide for anyone seeking to lead and effect change within their own organization or industry." Boston Globe
The executive director of the Permanente Federation argues that physicians are the key to creating a health care system that is patient-centered, safe, equitable, accessible and affordable. With the assistance of former Boston Globe journalist Kenney (Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience, 2010), Cochran draws on his years as president and chairman of the board of the Kaiser Permanente Medical Group in Colorado, where he developed and tested many of the ideas presented here.... Cochran calls on doctors, who have been trained to be healers, to expand their mission and take on a combination role of healer/leader/partner.... the book gives outsiders a peek into the inner workings of a large medical group.”Kirkus Reviews
Many doctors are feeling pessimistic about the future of the medical profession. Cochran and Kenny consider part of the remedy is for physicians to play the major part in any ideal health care system that is patient-centered, easily accessed, fair, safe, affordable, efficient, high-quality, and innovative.”Booklist
With a unique combination of poetic storytelling, technical mastery, and executive savvy, Dr. Jack Cochran and Charles Kenney offer a design and a call for the learning and leadership we urgently need in health care. In a terrain of political debate too often marked by confusion and reductionist claims, this book brings real wisdom and compassion. It is a must-read for those searching for a route to a new care system.” Donald M. Berwick, MD, President Emeritus and Senior Fellow, Institute for Healthcare Improvement
The core of this compelling book is the true story of how a dedicated, passionate surgeon took on a leadership role to help turn around a struggling health care organization. Both practical and wise, The Doctor Crisis is a must-read for health care leaders everywhere. Cochran and Kenney have managed to capture the discipline and ordinariness of the many small actions and encounters that together produce dramatic organizational change.” Amy C. Edmondson, Novartis Professor of Leadership and Management, Harvard Business School, and author of Teaming
In this time of tumultuous change, physicians have great challenges and wonderful opportunities. Cochran and Kenney effectively make the case for physicians to lead delivery system change, and clearly and persuasively show how physician leadership will be a critical success factor as we build a better health care system for our patients and our communities.” Gary S. Kaplan, MD, Chairman and CEO, Virginia Mason Health System
The evidence is overwhelming that the American medical system is broken, yet few people have offered the wisdom, grit, and optimism to see a better future and reach for it. Cochran and Kenney have done just that. With extraordinary humanity and solid data, they remind all of us that status should not be confused with leadership. Each of us must learn from other disciplines, live with purpose and transparency, and make sure the joy in medicine is sustained for the next generation.” Nancy L. Snyderman, MD, FACS, NBC News Chief Medical Editor, and Associate Clinical Professor, Head and Neck Surgery, University of Pennsylvania
Jack Cochran uses his personal experiences to draw important lessons for fundamentally transforming the US health care system. Because failure is truly not an option and the issues transcend mere money to encompass human life and well-being, everyone should read and heed Cochrans profound wisdom.” Jeffrey Pfeffer, Professor of Organizational Behavior, Graduate School of Business, Stanford University
A compelling portrayal of why physicians must lead and show the way to transformative change in health care. This book should be read by every physician who has lost hopeor is losing hopein achieving professional fulfillment.” Dennis S. OLeary, MD, former President, The Joint Commission
Jack and Charles have written an inspiring piece that illustrates the personal and professional attributes that physicians and health care workers today must embody in order to improve the quality of patient care and to lead innovation within an all-too-fragmented health care service. Textured with moving vignettes from patients and the clinical community, The Doctor Crisis challenges physicians to stand up and lead, to take action, and to prioritize learning and evidence-based medicine.” Professor the Lord Ara Darzi, PC, KBE, FRS, Paul Hamlyn Chair of Surgery and Chair of The Institute of Global Health Innovation, Imperial College London
The vision is compelling and provocative, that physicians and other clinicians should work together to be healers-leaders-partners. The authors compel us with the new work, and also enable us with a rich array of stories, examples, and tools to guide our own personal journeys of growth.” Maureen Bisognano, President and CEO, Institute For Healthcare Improvement
I have often been inspired by seeing firsthand in Colorado and other places how Dr. Jack Cochran and a great team of physician leaders transformed health careand I am inspired by the many examples and stories which illustrate how they got started and how they ended up transforming care in a fundamental way. Like many others, I often asked Jack whether he could write these powerful examples down. With Charles Kenny, Jack Cochran has done a fantastic job at preserving the narrative of captivating events as they occurred, while at the same time drawing helpful lessons for system leaders and policy makers alike. A great read for anyone involved in making healthcare better!” Nicolaus Henke, Global Leader of McKinseys Healthcare Practice, London
In our nations effort to improve health care quality, access and affordability, the doctor crisis is routinely overlooked. More than 80 percent of doctors say that the medical profession is in decline.” Three in five would like to quit.
Kaiser Permanente, one of the worlds leading health care providers, is an object lesson in the complex and frustrating challenges facing so many health care organizations today. When Dr. Jack Cochran took over leadership of the Colorado Permanente Medical Group in the mid-1990s, he oversaw high-quality medical teams providing excellent care, but dealt with organizational troubles so deep rooted that patients and physicians fled in droves.
In The Doctor Crisis, Cochran, now executive director of The Permanente Federation, and author Charles Kenney show how we can improve health care on a grass roots level, regardless of political policy disputes, by improving conditions for physicians and asking them to take on broader accountability. Doctors, they argue, are the key to making health care in the United States truly great, and we must do all we can to preserve and enhance the careers of physicians. They clarify the steps needed to take to support doctors so that they can focus on patient care, and offer concrete ideas for creating an environment and establishing systems that encourage doctors to put patients needs above all else.
Solving the doctor crisis is at the core of our ability as a nation to reach the major goals to which we aspire. We must solve it to improve the patient experience and health outcomes. And we must solve it to successfully implement the Affordable Care Act.
About the Author
Jack Cochran, MD, FACS
, is the executive director of The Permanente Federation. The Permanente Federation represents the national interests of the regional Permanente Medical Groups, which employ more than 17,000 physicians who care for 9.1 million Kaiser Permanente members. Prior to this role, Dr. Cochran served as executive medical director, president, and chairman of the board of the Colorado Permanente Medical Group for Kaiser Permanente. Dr. Cochran serves as a member of the board of directors of the Alliance of Community Health Plans and the UCSF Global Health Group Advisory Board. He is also a past president of the Consortium for Community Centered Comprehensive Child Care (C6). Dr. Cochran earned his medical degree from the University of Colorado and served residencies at Stanford University Medical Center and the University of Wisconsin Hospital. He is board certified in otolaryngology (head and neck surgery) and in plastic and reconstructive surgery.
Charles Kenney is the author of Transforming Health Care: Virginia Mason Medical Centers Pursuit of the Perfect Patient Experience, which received the 2012 Shingo Research and Professional Publication Award. He is the author of two other works: The Best Practice: How the New Quality Movement Is Transforming Medicine, and coauthor, with Maureen Bisognano, of Pursuing the Triple Aim: Seven Innovators Show the Way to Better Care, Better Health, and Lower Cost. He formerly worked as a reporter and editor at the Boston Globe.