The Doctor Crisis: How Physicians Can, and Must, Lead the Way to Better Health Care

Cochran, executive director of the Permanente Federation, and former Boston Globe editor Kenney (Transforming Health Care) argue that while health care reform talk may be loudest among politicians in Washington, doctors have a pivotal role to play in improving medical "access, quality and affordability" by solving the "crisis" of burned out and pessimist members in their own ranks. The authors point out examples of potential solutions, using the Oct. 9, 2001 separation of conjoined twins Lexi and Sydney Stark as an illustration of "American medicine at its best." Cochran used his leadership at Kaiser Permanente in Colorado to lay out a new "mission" for the medical field: to support primary physicians' careers, better the "patient care experience," and streamline the care process. At the heart of the transformation is what Cochran calls the "Learning Coalition": "physicians as healer-leader-partner" looking for "best practices" and applying them at their hospitals and offices. The authors also address issues of liability burdens, transparency in healthcare, payment reform, and bringing health care to the workplace and schools. They cheerlead for a nation that supports its doctors "so they can do their best for patients," and for physicians to set the stage for real health care change. (May)