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Berwick sees the possible in healthcare

September 10, 2014
by Lori Ashcraft
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Lori Ashcraft

I have a lot of heroes in my life—people who have walked a journey of recovery exhibiting courage and strength beyond imagination, people who against all odds have started recovery programs that really work and have great results. Some heroes inspire me to be my best self. They are the people who set a consistent example of excellence, who, through their example, show the rest of us that we are capable of being and giving more than we thought possible.

For me, Don Berwick is one of those people. A pediatrician, he is the former administrator of the Centers for Medicare and Medicaid Services (CMS) and former CEO of the Institute Healthcare Improvement (IHI). In June 2013, Berwick—a Democrat—announced his run for the Massachusetts Governor's office.

There is a lot to be said about the contributions Berwick has made to healthcare thus far. From his position at IHI, he played a major role in improving healthcare by highlighting goals and best practices. He had little time to make impact at CMS, though, and resigned from his position as administrator in 2011 due to unrelenting political pressure—he was installed by President Obama by recess appointment and ultimately would not gain Senate approval. Within healthcare, he has published 130 articles and is the co-author of several books.

I have now read everything I can find that Berwick has written. My favorite is “Escape Fire. Designs for the Future of Health Care” from 2004 , in which he uses the true story of men trapped in a wild fire to illustrate his perspective on the dire situation we face in reforming healthcare. In 1949, the leader of a crew of fire fighters purposely lit a fire at his feet to burn the consumable material around him, thus eliminating fuel for the wild fire. The leader was unharmed. The crew, however, followed their old methods—they ran like hell—and 13 of them did not survive. They did what they had been trained to do but ignored the solution that was right in front of them.

Berwick thinks we too have an answer right in front of us, and we are ignoring it, tinkering with old ideas that got us in this healthcare jam to begin with. His solution is summarized by the IHI’s Triple Aim: improving the health of populations; lowering costs; and improving the patient experience.

“A healthcare system should be pursuing health and well-being. It should be keeping you out of the hospital, not in it,” he told me during our recent discussion in his office.

On a personal level, I wonder what drives Berwick. It seems to me that he is driven by two things. First, he believes in the people who use health services. Consumers know what they want and need, and if empowered, can play the starring role in their healing and recovery. He also believes in healthcare workers who want to do what’s best for their patients.

“They want to have pride and joy in their work. They want to help people,” he told me. “But with the payment system set up wrong, which this one is, they live in a world where doing more seems to be the right thing to do.”

 He even believes in the politicians who make some crucial decisions about healthcare. He believe we all have the courage to change the way we do things once we see a way out of the dilemma we are in.

The second thing that drives Berwick is a desire contribute, with a sense of urgency. Many of us think we are here on Earth to improve the state of the world, but he says he is willing to reach common ground; listen for new solutions; repeatedly fail in his attempts at cooperation; and to keep trying if it brings us a step closer to making things better.

If we all start listening to our hearts we’ll be able to move past the fear that holds us in place and keeps us from moving to new ground, developing creative and meaningful ways to solve our problems. We can become who we were meant to be, individually and collectively.

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