While I haven't read any books by Jim Collins—author of Good to Great, Built to Last and How the Mighty Fall—I have a vivid memory of something he said in a keynote speech at a behavioral healthcare conference in Boston a few years ago. The most important quality of any leader, Collins said, is humility.
Dr. Berwick and the uncommon virtue of physician humility
I thought about that Monday when I heard CMS Administrator Dr. Donald Berwick respond to a question from an audience member at the America's Health Insurance Plans conference on Medicare and Medicaid in Washington. The attendee asserted that in healthcare, there is a strong focus on provider and patient responsibility, but she wanted Berwick's take on patient compliance. The start of Berwick's response gave insight into the kind of leader he is.
“I think people are really smart,” he said. “And I think they do what makes sense. And if I have a patient who's stopped taking a medicine that I think they should take, I don't view that as problem with compliance. I view that as a challenge with dialogue,” he continued. “Why did you stop? What do you notice that I don't see? What's in your way that I don't understand? I think the concept of partnership extends right to the patient.”
So then it's not a matter of demanding that already smart people somehow get smarter, Berwick said, but rather that there be “authentic conversations” between clinicians and patients about what they want and need and what stands in their way. In other words: Berwick operates not from on high, but on the same level with people he views as equals.
Understand: I'm not trying to go soft on a government official. There are many times when Berwick simply doesn't answer a question, or (in a way that is more polite than most) sidesteps one, as he did last week when Health Affairs editor Susan Dentzer asked what he meant by “soon” with regard to CMS' release of the ACO final rule. “Soon means imminent,” he replied.
But I think as Berwick's time is running short—his term is set to expire in late December if he doesn't receive Senate confirmation, and he won't—it's worth noting that he has walked his own talk when it comes to being a “trustworthy partner” and emphasizing that the only way to change healthcare is if everyone is engaged in the effort: clinicians, hospitals, payers, CMS, and patients.
Physicians are known for many things, but “humility” doesn't always top the list. It's nice to know that the physician who serves as the leader of a government healthcare agency responsible for 100 million beneficiaries has some.
You can follow Jessica Zigmond on Twitter @MHJZigmond.
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