Does White House Chief of Staff Rahm Emanuel’s now famous remark (uttered in various ways by countless others previously) that one should “never fail to take advantage of a good crisis” pertain to cardiology right now?

Are we taking advantage of the nightmare we’re dealing with? The traditional management view about ‘what is a crisis’ is that it is an event that can destroy or adversely affect an entire organization or business. However, according to Northwestern University economist Daniel Diermeier, the strategic view is that a crisis is ‘a decisive moment, a turning point for better or worse.’ 

What turning point(s) are we approaching with the Medicare Rule and erosions of clinical practice revenues, health system reform, generational changes, and/or the explosion of scientific knowledge and consumer information? For me, delivery and payment system reforms that will become essential as the nation works to slow the rise in health care costs will create monumental changes. How do we respond? Do we react or lead?

It seems to me that the ‘better or worse’ possibilities will be dependent less on what we independently decide to do as compared to how what we do affects our customers -- that is our patients. We’re engaged now in a crisis management strategy related to the Medicare Rule and to negative potentials in health care reform. We are definitely reacting in these regards. That is necessary; but we also better have an achievable vision of what a viable, sustainable future of health care might be -- one that works for a majority of patients (voters). 

The current administration and Congress have at least for the moment lost the trust of a majority of citizens. Individually, patients still seem to trust their own doctors. But trust is more complicated than that. Economists claim consumer trust and credibility for businesses have been demonstrated to be related to 4 major factors:

• Competence and expertise -- 15-20% of the total trust pie;
• Honesty and openness -- 15-20% of the pie;
• Dedication and commitment -- 15-20% of the pie; and finally
• Empathy and caring -- 50% or more of the pie!!!!

If our current crisis is an opportunity, we will need to keep these things in mind as we move toward solutions and a better future. We can’t promote ongoing vitality for the profession(s) and cardiology without the support of our patients, and everything we do needs to be grounded in making sure that is our central and most important consideration.

 

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