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  • Writer's picturePaul DeChant MD, MBA

Surviving Existential Threats in Healthcare

Many aspects of our society have faced existential threats this past year, and healthcare has been at the forefront.

COVID-19 has overwhelmed hospitals and radically changed outpatient care. Everyone – clinicians and those providing support services alike – have been stretched to their limit and beyond. And, the pandemic impact continues to evolve.

Over the next few months I'll be interviewing healthcare leaders asking about their perspectives on lessons from 2020, innovations impacting organizational resilience and clinician burnout, and their hopes for 2021.

This week I spoke with Steven Strongwater, MD, President and CEO of Atrius Health, the largest independent physician-led healthcare organization in the Northeast, with over 700 physicians and 300 advanced practitioners caring for 730,000 patients. Steve has been an advocate for clinician well-being for many years, with a strong focus on reducing data entry and administrivia burden on physicians.

Some key points from our discussion:

  • COVID has overwhelmed healthcare organizations, essentially eliminating their capacity to focus on anything else. With “all hands on deck” to manage the impact of the pandemic, activities such as process improvement have been put on the back burner.

  • The pandemic impact continues to evolve. First there was the immediate change in practice to converting outpatient care to telemedicine/virtual care and inpatient ICU capacity growth. Over time the focus has shifted as virtual care has impacted EHR in baskets, and with approval of the vaccine, implementing a plan to immunize staff and 700,000+ patients.

  • The next 18-24 months will likely present a new existential threat. Once the population is widely vaccinated, the impact of the new Biden administration work on healthcare policy and regulation will begin to come into play. The urgency to deal with the escalating healthcare costs while addressing health equity and expanding Obamacare and/or Medicare for All will put significant strains on providers. The significance and risk of this next existential threat will depend on the degree of reimbursement reduction, the speed of the roll out of such programs, and the ability of provider organizations to transform their delivery models.

  • There is a critical need to assure adequate staff to support front line work to avoid an epidemic of burnout.

Successfully navigating these perilous waters will depend on organizational resilience – the ability of an organization to rapidly adapt as the world changes around them.

Such agility requires a management system and culture that supports clinicians in their daily work, empowers them to solve local problems, and aligns everyone around enterprise success – or at a minimum, organizational survival until these impacts begin to wane.

I’m interested in your thoughts on the challenges healthcare faces in 2021, and how we manage through the coming year. You can share your comments below.

If you’d like to learn more about effective approaches to managing healthcare’s existential threats, you’re welcome to reach out to me at


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