Back to Balance in the Art, Science, and Business of Medicine

Mar 12, 2023 | Articles

By Michael O’Connell

I’ve had the privilege of working with Dr. Halee Fischer-Wright, President and CEO of the Medical Group Management Association (MGMA), on an MGMA committee, and she gave me a copy of her book “Back to Balance: The Art, Science, and Business of Medicine.” In it, she shares her perspective on what she believes are the five paradigm shifts needed to get back to balance the art, science, and business of medicine. 

The paradigm shifts are to move from: 

  • Money as an incentive to time as an incentive 
  • Complexity to more simplicity 
  • Metrics to more relationships 
  • Process-driven to a more outcome-driven approach 
  • A zero-sum (I win, you lose) to a non-zero-sum (we all win) approach. 

Based on Dr. Fischer-Wright’s thirty-plus years of experience as a physician and healthcare leader, she shares that we have lost our focus on strengthening the relationship between the physician and the patient through smart science and good business practices needed to build the trust to achieve our desired outcomes. She makes us think hard about what is needed for us to effect positive change with these questions or comments:

  1. “How do we use our time to encourage good outcomes?” Be a more active listener, build eye contact with those around us, and show empathy to help build more trusting relationships.
  2. We are all busy, but are we busy on the right things? We need to move to a new focus on essentialism. Instead of working on 20 different things with mediocre results, let’s work on 3-4 things and do them well. Our medical practice lives are complex; let’s make life simpler by bringing balance back into our lives by bringing simplicity back in the art, science, and business of medicine.
  3. Medical care is personal. It takes time for us to get to know our patients and their families. What looks good on paper and what drives best practice outcomes can be two different things, and we must balance the achievement of our metrics with the important relationships we develop with each other in caring for our patients. We need to explore better ways to build the best outcomes for our patients in a way that incentivizes good provider behavior.
  4. Instead of asking “How do we apply more science and business to develop the best practices?” we need to ask, “How do we get happier patients, lower cost, and better quality medicine?” We need to begin with the outcomes we want with a focus on the patient’s welfare and what it will take to get the best results.
  5. Many people believe that in order for one to win, someone else has to lose. But that is not true and it doesn’t have to be that way. The health care industry is one where everyone should be able to win together. We can do so by asking the right questions, shifting some of the paradigms in thinking that are holding us back, and beginning new conversations that puts patients at the center of healthcare again.

CaduceusFinally, she shares with us a new description of the Symbol of Medicine – the Triad of Caduceus, a short golden rod entwined by two snakes and topped by a pair of wings. She explains that the caduceus can guide us to a new way of thinking and behaving. The golden rod is the science of medicine, the snake that coils to the left as the art of medicine, and the snake that coils to the right as the business of medicine; all three in balance are ready to help those wings – our patients – take flight. It’s an inspiring way to consider how we can work together in balance – art, science, and business – to care for our patients. 

At CAHL, I hear many stories about how our physicians, advanced practice providers, and staff work together to explore the most effective ways to balance the art, science, and medicine together in caring for the patient. Whether it’s development of a team-based approach, abstracting and indexing papers in the medical record to better monitor a patient’s care, or seeing patients through a same day access program, I see everybody working to bring back balance into the Art, Science, and Business of Medicine. I congratulate Dr. Fischer-Wright for writing a book to make us think about how we can work together to create a new model of care that transforms all of us to achieve our greatest potential to achieve our desired outcomes. At CAHL it is clearly evident that we are committed to work to that end. 

Best Regards,

Michael O’Connell, MHA, FACMPE, FACHE, is the Immediate Past President for CAHL