This post was originally published here, as a manifesto for healthcare practitioners, but since I feel so strongly about it, I’ve included it on this site so you have an idea of how we approach healthcare here at Proactive Rehabilitation & Wellness. I have made significant edits to make it more relevant to this site and the audience we have here.
Better Outcomes: A Manifesto for a New Healthcare
Let’s get real: Healthcare is broken. You know it. I know it. Anyone who has ever received care in a clinic, hospital, or rehab center, knows this to be undeniably true. You feel it everyday when you try to navigate this broken system. Your clinicians feel the burden of time-based productivity metrics, utilization rates, and the expectation to behave like cogs in a giant, soul-crushing machine aimed at extracting revenue from you, our patients in exchange for “units” of treatment.
Day after day, millions of patients just like you go to clinics, hospitals, and other healthcare facilities to address issues related to your physical, emotional, and mental health. More often than not, you are met with indifference or bulldozed by procedures. And that’s not surprising, when the healthcare environment pushes clinicians to the point of burnout and apathy.
Healthcare should be about one thing: PEOPLE! Yet how many clinics, organizations, or healthcare professionals live their lives by the numbers? Metrics & spreadsheets drive most healthcare decision makers and administrators. That leaves patients -the people we serve- lost in the mix. Patient’s like you feel lost, forgotten, and ignored by a system that prioritizes efficiency & productivity over your own personal experiences, priorities, or goals.
That’s probably why nearly 70% of patients never complete their course of care.
That means 7 out of 10 patients never end up achieving their goals, desired outcomes, or receiving the full benefits of the treatment they seek out.
It’s time for clinicians & healthcare organizations to finally stand up and say what we’ve all been thinking for so long: enough is enough!
It’s time for healthcare organizations to commit to serving the individual needs of each unique patient that they are charged with serving.
To do this, we need a new framework, a new paradigm, a new way of looking at this noble profession of healthcare. Below are the 7 foundational commitments we will make to each of you —our patients:
Commitment #1: We will be focused on purpose— your purpose.
We believe that every person has something they were created to do. To live is to fearlessly pursue the calling on your heart, regardless of whether or not you achieve great things. We are committed to helping all of our employees and patients find holistic wellbeing so that they are unafraid to say “yes” to pursuing their unique role in history and discover their place in the world.
We are committed to helping you live your purpose.
Commitment #2: We will partner with you —to serve you together.
You are best served when specialists collaborate. Different specialists bring different perspectives, which lead to better diagnoses and better treatment plans. You shouldn’t have to spend a month or more scheduling different appointments with different healthcare providers to receive care for one ailment. We are committed to working bringing specialists together in an integrated team, so that along with you, our patients, we can develop a holistic plan to help you heal.
When we serve the patients together we will achieve stronger patient outcomes and higher patient satisfaction. We are committed to working in partnership with both you and any other clinician managing your care.
Commitment #3: We will be a guide, not a crutch.
We believe you should be empowered as drivers of your own healthcare. Too often, healthcare professionals use technical jargon that makes patients like you feel anxious and afraid to look for alternative options. What we do isn’t rocket science. We are here to help you —our patients— understand not only your current situation, but the precipitating physical and psychological factors that contribute to your symptoms. By taking a holistic view, we can determine exactly what is going on in your body, why it’s going on, and work with you to develop the right treatment plan.
Our goal is to be your healthcare translators and guides, providing the tools and resources you need to take charge in working towards healing.
Commitment #4: We will treat the whole person —not just symptoms and diagnoses.
People are not metrics, numbers, or data points. What happens in your body, mind, and social environment all impact each other and must be accounted for in diagnosing and treating your pain or limitation. Each specialist and clinician must have the humility not to view patients like you solely through the lens of their expertise, or as a sum of their symptoms or diagnosis. Instead, it is crucial for us to take into account all contributing factors, as well as the input of our colleagues so that the whole person is treated. When we view patients like you in your entirety as human beings we can address the root causes of pain, provide deeper understanding, and chart better paths toward lifelong recovery.
We commit to see you, as you: a unique individual, experiencing a unique set of circumstances, on a unique road to recovery. And we want to tailor our assessment and treatment to meet you where you are at, not to try to fit you into cookie-cutter, one-size-fits-most treatment programs.
Commitment #5: We will prioritize building meaningful relationships with you —our patients.
Healthcare is a relationship. At its core, healthcare is a fundamentally human experience, and human experience is founded on relationship. As rehabilitation & wellness clinicians, we spend more time with patients like you than most primary care providers, surgeons, or other specialists who refer you to our clinic. No matter who walks through our door, we are in it for the long haul with every patient, every time. It doesn’t always take neurosurgery to change a life. When a patient like you knows they are seen, heard, and empowered, they recover the dignity of their agency and the freedom to live full and vibrant lives.
As a result, we commit to being there for you, through thick and thin, and to build relationships built on trust, understanding, and mutual respect.
Commitment #6: We will embrace transparency throughout the entire treatment process, including financial costs for our patients.
You know what sucks? When you call a clinic to set up an appointment for an evaluation or treatment that your doctor prescribed and you can’t get the answer. The answer to the questions “How much is this going to cost me?” Most of the time, clinics respond with something like, “With your insurance, your copay is $X”. And that’s not untrue. That is the copay. But everyone knows it: about three months after that appointment, you’re going to get a bill, and hopefully it’s small. Sometimes it’s a “what the hell is this!?!?” bill.
Either way, this has to stop. Healthcare is about wellbeing, period. No patient should have to feel stressed or worried about decisions to be made or surprise bills, and we are committed to always being transparent. When we make a treatment plan, we don’t just look at charts. We sit down with every patient to understand what their limitation is, what their unique goals are, explain what we see through our expertise, and then come up with a plan together. When we create that plan, we don’t provide estimates, we strive to provide exact dollars and cents so that the you can make informed decisions. Simply put, we are here to serve and empower you, our patients.
Commitment #7: We will commit to leading the change we want to see in healthcare.
We are on a mission to radically transform healthcare. The systems in place have stopped seeing patients as human beings, and can even cause material harm in their one-size-fits-most approach. No two patients are the same, and no two treatments should be the same. When we do our job correctly, you —our patients— shouldn’t feel the need to have something done to you. We should help you should discover your own capacity to do for yourselves. Like I said, this isn’t rocket science. You just need a guide that can help you get where you want to go. That’s what we’re here to do.
It is time to make healthcare human again, and we are here to lead the change.
A higher Standard
It’s time for a change. It’s time that we, as clinicians, begin to return our attention back to where it belongs: you, the patient, your goals and priorities, and your desired outcomes. For too long we’ve allowed third-party payers, administrators, and number-crunchers to dictate how we provide care. Driven by time-based productivity metrics, utilization, and treatment units, clinicians continue to work to the point of burnout, while you — our patients— receive cookie-cutter run-of-the-mill assessments and treatments. Patients like you, disengaged from treatment, decide that there are other options out there to help them achieve their goals. Or, sometimes you simply give up all together. You drop off the schedule, cancel appointments, or even “ghost” your clinician —never to be heard from again.
We want to change that. We’re on a mission to create a world where skilled, competent, and caring clinicians serve and care for engaged patients to promote better clinical outcomes, unmatched patient satisfaction, and lasting relationships.
Given the right goals, strategies, and processes, clinicians and organizations can create uniquely awesome patient experiences that lead to better relationships, better outcomes, and happier patients. After all, healthcare is about one thing: the patient! That’s where we need to focus.
Rafael E. Salazar II, MHS, OTR/L (Rafi) is the CEO & President of Proactive Rehabilitation & Wellness, as well as the Principal Owner of Rehab U Practice Solutions. He has experience in a variety of rehab settings, working with patients recovering from a variety of injuries and surgeries. He worked as the lead clinician in an outpatient specialty clinic at his local VA Medical center, where he worked on projects to improve patient & employee engagement and experience throughout the organization. He also has experience as a faculty member at Augusta University’s Occupational Therapy Program, as a Licensed Board Member on the GA State OT Board, has served on several committees for the national OT Board (NBCOT), and as a consultant working for the State of Georgia’s DBHDD. He is also on the Board of Directors for NBCOT.