by Thomas Dahlborg

A physician friend of mine from a well-known, local health care system recently confided in me that he's so tired and burned-out that he's thinking of leaving the practice of medicine.

As a primary care physician, he feels his role has moved further away from that of a healer and more into that of a "production worker."

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Rather than focus his energy on ensuring that his patients are best positioned for optimal healing, he feels pressure to ensure that he's triple-booked every fifteen minutes in an effort to generate the required 30 "relative value units" (RVU's) per day and thus earn his salary.

Another friend of mine, a resident physician shared similar sentiments. Her residency program seems to emphasize the need for speed when it comes to completing patient assessments. Less emphasis is placed on the best ways to position the patient for optimal healing. Instead, it's all about productivity.

Human beings are complex and multi-faceted. We are complex adaptive systems, as complexity science guru John Holland would say. As such, we're comprised of many interconnected pieces, have the ability to change based on past experience, and to make adjustments based on emerging needs and new realities.

I'm not a clinician, but I do believe that positioning people for true healing requires a complete understanding of the many dimensions that affect each patient (e.g., physical, mental, emotional, spiritual, financial, environmental) and the reactions thereof. It requires having time to develop a true relationship, understanding and trust between patient and physician.

And yet our health care system continues to rely on brief encounters between physicians and patients as the focus remains on revenue generation. Funding mechanisms are based on productivity and thus result in limited time between physician and patient. The result is often physician dissatisfaction and burnout.

Thomas H. Dahlborg, M.S.M., has 21 years of experience creating competitive advantages, analyzing customer expectations, and developing and implementing focused and aligned strategic deployment plans. He's executive director of True North, where he focuses on improving growth while ensuring access for the uninsured and the elderly. Formerly he served as the chief business strategy officer at Network Health, a comprehensive Medicaid health plan based in Cambridge, Mass.; and was COO for the U.S. Family Health Plan at Martin's Point Health Care in Portland, Maine.