The Doctor Crisis

by Jack Cochran, MD and Charles Kenney

Review by Edward Ellison, MD

Perm J 2014 Fall; 18(4):95 [Full Citation]


In their book, The Doctor Crisis, Jack Cochran, MD, and Charles Kenney send a clear and compelling message to physicians and health care executives seeking to heal a health care system in need: to fix the health care crisis, we must first fix the doctor crisis.

Many physicians today are struggling under the burden of increased regulatory pressures, reduced reimbursements, and bureaucracy, all of which have contributed to levels of physician burnout of epic proportion. And yet, according to the authors, engaging physicians not only as healers, but as partners and leaders, creates a path forward that heals the system from the inside out.

Cochran states, "We can't legislate our way out of the problem. We must learn our way out of the problem. Improved quality will ultimately be the most powerful force for controlling costs."1p20 Engaging physicians, Cochran and Kenney state, would be that powerful force to mobilize for change.

Physicians by their very nature want to do what is right and best for their patients. And although physicians are often weighed down by the many challenges they face today, by addressing what holds them back, helping them to grow and to lead, they in turn will improve the health care system.

As Cochran states with such clarity, "… physicians must step up and solve the health care crisis. We must be part of the solution; we must be creative and bold and stand up for our patients."1p55

In making their case, Cochran and Kenney create an eloquent juxtaposition of data, biography, and leadership philosophy. The authors weave together stories of success and failure within the health care system, revealing its strengths and weaknesses. They note the relentless challenges negatively affecting the morale of hundreds of thousands of physicians who want nothing more than to "put their patients first, every step in the care process, every time."1p1

With a keen knack for storytelling, Cochran and Kenney tell powerful stories that touch our heads and our hearts: from opening the book with the inspiring story of a young boy with a cleft lip who convinced his anxious father to allow him to undergo reparative surgery, to the harrowing account of 22 surgeons and a large multidisciplinary team representing the best that medicine has to offer as they operate on conjoined twins, to Cochran's experiences and challenges as the Executive Director, President, and Chairman of the Board of the Colorado Permanente Medical Group. Each story demonstrates the challenges of health care and what remarkable things can be achieved when we are at our very best.

Cochran also outlines his leadership learning journey, which includes practical leadership tips and practices that have played a critical role in his development and in that of other physician leaders. Included among them are the importance of active listening, engaging and valuing physicians, and setting clear expectations. He discusses the impact key learnings from the book Play to Win2 had on the transformation of the Colorado Permanente Medical Group. Cochran believes that committing to the preservation and enhancement of physician careers frees physicians to focus on optimizing the patient care experience and streamlining the care process.

I strongly recommend The Doctor Crisis to physicians and to every leader in health care. Health care, at its heart, is a team sport. Success lies in bringing together all the compassionate, dedicated professionals who care for patients. Physicians have always played a critical role as leaders of our health care teams. By the very nature of their positions, they set the tone in every setting, influence every system, and are looked to by others as leaders. While asking them to engage, to value, and to listen to others, we also need to engage, to value, and to listen to them.

The Doctor Crisis is a valuable read for anyone seeking to understand the essential role physicians play in creating solutions for care delivery, and as a result, their critical involvement in making health care in the US all that we need it to be.

1.    Cochran J, Kenney C. The doctor crisis. New York, NY: Public Affairs; 2014.
2.    Wilson L, Wilson H, Blanchard K. Play to win! Choosing growth over fear in work and life. Austin, TX: Bard Press; 2004.


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