2019 CNA Annual Conference

Health care continues to improve the quality and predictability of care outcomes so patients can experience improved health and decreased suffering. But we still see daily examples of uneven quality and access and an increasing problem of affordability for patients and families. Physicians are not more important than all of the other stakeholders in health care, but we do have disproportionate impact on outcomes due to the many touch points where we significantly impact the process and/or outcome. This disproportionate impact should engender disproportionate accountability to “opt in” to all the ways health care touches our patients and families : physically, socially, psychologically, and financially. We track the evolution of health care from both the patients view and that of the physician. We follow the rapid growth in knowledge, technology , and both diagnostic and therapeutic options. This marvelous increase in knowledge nd capability has also created major increases in complexity that are radically forcing change that is pressing on both patients and physicians. We bring the past as a source of learning to the present and offer a clear eyed view of the impact of complexity as described , but add more development of added complexity as patients are cured or stabilized from difficult illnesses and go on to develop additional conditions. All of this lands in the middle of the doctor-patient relationship and has made many aspects of the experience better, but other aspects very difficult. We show how the current state for both patients and physicians must change and improve and outline how physicians must not become victims to all the change, but become leaders in improving care in this age of technology and information explosion.. Details of how the model of one doctor, one patient, and one paper chart can be enthusiastically changed into care that is delivered using technology, information, and teams to create excellent and personal care is demonstrated. Tangible examples add proof points to this very positive future state that can create a health care system that patients want, need, and deserve but also provide physicians a growing sense of professional confidence and pride in their work and being the kind oh healing physician they believe has been and should be their standard.