What good can come from a terminal cancer diagnosis?
For my family, it was a calling to transform healthcare. And our calling, oddly enough, began with a different kind of call.
I was in medical school when my father, Dr. James Chen, a 54-year-old Primary Care Physician in Miami, Florida, called on the phone and asked for a ride home from his doctor’s office. He was too shocked to drive. Dad went to the doctor because his upper lip was numb. A CT scan revealed a golf ball-sized mass behind his nose. After a biopsy, his doctor said he had an incurable carcinoma and less than two months to live.
Before Dad called, I lived life at breakneck speed. In the blink of an eye, however, life stopped. I remember thinking, “Do we let Dad live his last days to the fullest? Do we fight for a few more months?” Then I remembered – I was getting married in three months. I called my fiancé Jessica. She was also in medical school and understood both the diagnosis and my need to have my father at our wedding. We got married the next day..
We were standing at the altar when the pathologist we contacted for a second opinion called regarding Dad. He said he thought the diagnosis was wrong and the mass was a potentially curable Large-B cell lymphoma. Jessica would agree – that phone call was the best wedding present ever.
I spent my “honeymoon” traveling with Dad to a top cancer center and trying to get him an appointment with a doctor. Back home, others were trying to gather records. We came to an alarming discovery — our family of doctors was not equipped to overcome the complexity, inefficiency, and ineffectiveness of a healthcare system that was working against us. We sat helpless in the ER waiting room when Dad went in for blood clots, neutropenic fever, seizures, and even a stroke. We cried as Dad suffered through multiple rounds of chemotherapy and radiation. We mourned our loss of control, and we considered things like purpose, hope, and the patients back in Dad’s medical center each day.
We wondered, “Who would fight for them? Dad summed up our feelings perfectly. “If a family full of doctors with resources and connections can’t navigate this system, what chance do my patients have?”
During his treatment, Dad spent his time looking for ways to relieve his patients’ suffering: tracking their visit flow and wait time, building tools to track hospitalizations, bringing actionable data back to doctors, and integrating health plan data to understand key focus areas. We made it through our nightmare through God’s mercy and grace, and Dad reached remission.
But as one fight ended, we took up another. We channeled our suffering into a vision to reach more patients and more communities. Empowered by technology, we expanded beyond that single medical center so that other seniors and their families wouldn’t suffer at the hands of a broken healthcare system the way we did. We grew from one medical center to two, then three, and before we knew it, six.
Our outcomes and service were so impressive our health plan partners asked us to go to other markets. They wanted to see if our approach was scalable. We invested in teaching doctors to learn a new way to care for patients, a business model built on the full risk and completely distinct from fee-for-service, and we significantly raised expectations on how we serve our patients.
We standardized not only selection, onboarding, and training but structured regular meetings to continuously re-focus on the sickest patients. We built our own electronic health record system, designed by doctors for doctors, that allows rapid cycle innovation and focuses on patient outcomes. Each center we built was designed to care for between one and three thousand seniors. Hospitalization rates dropped 40-50 percent consistently, and patient satisfaction went through the roof.
Today we have more than 100 medical centers in 15 states across the United States and take care of thousands of patients. We can summarize our success in three words: “Accountability, Coaching, and Simplifying.” Accountability means owning our patient outcomes and learning how to influence behavior change. Transforming healthcare starts with the mindset of being accountable for outcomes. Coaching means coaching for health versus consulting for sickness. Coaches set high but achievable goals. They check in frequently to measure progress, make targeted corrections, and celebrate success. Coaches inspire patients to move to a higher state of health. Simplifying means we simplify for action rather than add complexity. We don’t give patients 10 things to change. We work on one at a time and ensure each change sticks before moving to the next. The more we simplify, the further we get.
It shouldn’t take suffering to transform healthcare. If we want a beautiful system that will be there for our patients, our family members, and even ourselves, we start by being accountable for outcomes, coaching for health, and simplifying for action.
Dr. Gordon Chen is the Chief Medical Officer of ChenMed and Co-Author of The Calling: A Memoir of Family, Faith and the Future of Healthcare
By Gordon Chen, MD.