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React to healthcare change like an NFL quarterback

January 7th, 2014

by Kent Bottles

Why did a post-season press conference with Philadelphia Eagles quarterback Nick Foles get me thinking about how physicians respond to the transformation of the American healthcare delivery system? For those of you who don't follow the Eagles or NFL football, Foles emerged this year as the quarterback with the highest passer rating of 119.2 for the entire season.

But it is the Foles who answers tough questions from the Philadelphia sports press after a loss who made me think about physicians and change in healthcare. After a loss, every Foles press conference reveals the following...


  • Foles owns up to his mistakes and discusses them calmly
  • Foles does not throw his teammates under the bus, even when the mistake is clearly their fault
  • Foles goes out of his way to emphasize how much he cares for his teammates
  • Foles refuses to bask in personal glory and always credits the whole team, including coaches
  • Foles talks about how much he wants to learn from mistakes and how he wants to get better every single day
  • Foles allows himself one day to reflect on a game and then moves on to trying to become a better quarterback and teammate

I can label much of what I do professionally these days as physician engagement. During my classes at Thomas Jefferson School of Population Health in Philadelphia, in my keynotes to professional societies and in my facilitation of leadership retreats, we talk a lot about how physicians need to change to become leaders in a transformed healthcare delivery system.

The physicians I work with can be divided into two large groups: 1) Doctors who want to remain independent and 2) Doctors who have already become employees of large integrated delivery systems. Members of both groups are learning in 2014 that physicians need new competencies to be considered leaders in the new world of American medicine.

The transformed healthcare delivery system will require doctors who have the following competencies:

  • Ability to delivery evidence-based medical care that reflects up-to-date medical science
  • Attitude that welcomes physician report cards as a way to get the feedback necessary to improve performance
  • Attitude that welcomes efforts to increase patient-centered care and patient satisfaction as reflected in survey results
  • Ability to function as part of a team that may not always be physician-led
  • Focus not on individual practice but on how the entire system coordinates care across the continuum
  • Ability to delivery low-cost, high-quality care that is paid by a value-based system
  • Ability to utilize information technology and emerging digital technologies in their care of patients

I wish I could report from my interactions with physicians in the field that they all respond like Nick Foles does in a press conference after a tough Philadelphia Eagles loss. My experience has been that the current attitudes of American physicians fall into four categories:

  1. Physicians who ignore all the changes and continue to practice the way they always have
  2. Clinicians who intellectually recognize the need for change but are paralyzed and unable to make the necessary adjustments
  3. Doctors who have just given up and are counting the days until they can retire
  4. Physicians who truly believe they can be part of a team that delivers high-quality care in a better way than they have in the past and who accept the challenge of providing the practitioner's perspective to the system approach of integrated care

It is vitally important that physicians have increased input into how we construct a better healthcare delivery system. A young NFL quarterback just might have some suggestions on how we as physicians approach the daunting challenge of becoming better professionals.

Kent Bottles, M.D, is a lecturer at the Thomas Jefferson University School of Population Health and chief medical officer of PYA Analytics.


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