*This piece is based on the introduction to the book Better Outcomes: A Guide to Humanizing Healthcare. I actually had someone ask specific questions about each chapter of the book to develop this series; so it’ll read like a Q&A session with the author.
Let me just say it plainly: healthcare is broken. And I think most people who work in it — or have needed it recently — already know this. You feel it every day. I felt it for years before I finally decided to write about it.
The burned-out clinicians shuffling between back-to-back appointments know it. The patients who fill out the same intake paperwork at every new provider, retell their entire medical history to a clinician who clearly hasn’t read a word of it, and leave feeling processed rather than heard — they definitely know it.
But here’s what I don’t think gets said enough: the problem isn’t a shortage of talented clinicians. It’s not a technology gap. It’s not even just the insurance system, as maddening as that is. The real problem is that healthcare, somewhere along the way, stopped being about people.
Here’s an interview I did on the book a while back:
What’s the actual framework for fixing the problems in our healthcare system?
That’s what my book, Better Outcomes, is built around. I lay out eight commitments for what I’m calling a “new healthcare” — not a utopian fantasy, but actual, implementable shifts in how clinicians and organizations operate day to day:
- Adopt a Biopsychosocial Approach
- Build Meaningful Relationships
- Put People Ahead of Policies
- Confidently Communicate Value
- Prioritize Patient Engagement
- Embrace Transparency
- Forget Time-Based Productivity
- Lead Our Patients
Each of these is worth its own deep dive — and that’s exactly what this series is going to do. But the thread running through all eight is the same: healthcare is fundamentally a human experience, and the moment we lose sight of that, we lose everything that makes this work worth doing.
Now, each of these eight changes or commitments approach the problem from a provider-side. However, they can also provide a framework or philosophical overview for the other involved stakeholders in healthcare: payers, policy-makers, and patients.
Who is this for — big hospital systems or small clinics?
Both, honestly. I’ve worked in a VA hospital, I’ve consulted with large healthcare organizations, and I run my own outpatient rehab clinic. The problems I’m describing show up everywhere. The pressures look a little different at different scales, but the core failure is universal: somewhere between the referral and the discharge, the patient stopped being the point.
The good news is that the solutions scale just as widely. Some of these changes require organizational buy-in. But a surprising number of them start with one clinician deciding to do one thing differently with the very next patient they see.
What’s the one thing anyone could do differently starting today?
Try this. At the end of your next patient encounter, ask: “Is there anything about your situation I haven’t asked about yet?”
That’s it. One question. Thirty seconds. It costs nothing. But what it communicates — I see you as a whole person, not just a diagnosis — can completely change the trajectory of that patient’s engagement with your clinic.
The biggest shifts often start with the smallest things. That’s been true in my practice, and I’ve seen it hold true for every clinician and clinic I’ve worked with.
All content in this series is drawn from Better Outcomes: A Guide to Humanizing Healthcare by Rafael E. Salazar II, MHS, OTR/L (Business Expert Press, 2022).
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Join Rafael E. Salazar II, MHS, OTR/L (Rafi), principal of Rehab U Practice Solutions and host of The Better Outcomes Show as he explores the possibilities of a new healthcare. Guests range from clinicians trying new techniques and treatments to executives and entrepreneurs exploring new technology, innovative service delivery methods, business models, and organizational structures. Grab a copy of the book: Better Outcomes: A Guide to Humanizing Healthcare. Or, hire Rafi to speak at your organization or event.
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