Maulik Joshi, DrPH – President and CEO, Meritus Health

President, Proposed Meritus School of Osteopathic Medicine

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Another Top Ten List – This one is Timeless

The start of a new year brings resolutions and a sense of goal setting – thus, another top ten list below. But unlike others, this list is not specific to large health systems or rural health systems or any subset of health systems. This list is applicable to all healthcare delivery organizations. Perhaps more important, this list isn’t just applicable to the next 365 days. This is a list of must do’s that will be relevant to healthcare delivery organizations for years, regardless of the emergence of big data, AI, disease outbreaks and many other “disruptions”. Not only is it a must-do, this list can be considered an organization’s motivation, containing the reasons to get up in the morning. These are exciting times, and remembering the core of what our healthcare delivery organizations can do is what makes our field important. How big you are, where you are, what your payer mix is – none of these factors will serve as barriers or enablers to doing these must-do’s to make health and healthcare better. As leaders, these exciting must-do’s are being done by many – but the opportunity in this list is finding the way to complete these tasks more efficiently. It is for you to judge if this list stands the test of time:


Top Ten Timeless Must Do’s for 2024 and Beyond

  1. We need to keep increasing access

You can’t have great care if you have no care. For many of us who are reading this, access is not a major issue. If you are in the healthcare field, you have ways to be seen when you want to. But many don’t have that “inside baseball luxury”. As leaders, we need to keep thinking about increasing access for all – through telehealth, face-to-face, in remote settings, mobile settings, and more – multiple ways. Seamless, easy access to see providers when you need is a continued opportunity for us.

  1. Quality is still the best measure of success

Number of lives covered, number of facilities, providers on staff, comprehensiveness of services are all key measures of organizational capability. However, the key measures of how well does an organization make a difference in lives are quality measures. Although they are imperfect – infection rates, harm rates, wait times, mortality rates, complying with best practices – those are the types of measures that signal how good a healthcare organization is. Let’s keep leading with quality.

  1. Money doesn’t solve everything

Money is absolutely a factor in many decisions, but it’s not everything. A good salary and resources to support you in the work are all critical and should be addressed. People deserve a livable wage and that keeps increasing. However, as important are things such as how well the team works, the larger goals of the organization and the feeling of belonging. More money is one, but not often the major driver of an employee’s pride and value in their workplace.

  1. The social aspects of life impact health more than medical care

Certainly not to diminish the value of the work of great doctors, nurses, therapists and other medical care providers, but the other parts of life are shown to impact one’s well-being even more. Having healthy food, getting to your next appointment, not worrying about paying the utility bills, providing decent housing for your family – all these and many more are the major drivers of health. As leaders, we need to continue to invest our time, attention and resources to when it is said “that life gets in the way.”

  1. Recruiting and retaining talent will always be a priority

It is more pronounced now because there is no short-term solution, but finding and retaining the best talent should be the thing leaders think about a lot. I mean a lot. As much as technology will grow in healthcare, for the foreseeable future, people are still the number one asset and expense for healthcare delivery organizations. Cultivating leaders, investing in coaching and building a team culture – these are the softer skills, sometimes involving conflict, but necessary to leverage the best people for the best work. We can’t accomplish anything if we don’t have the right people on our teams.

  1. It is our obligation to make healthcare less costly

For those of us in healthcare, we feel that pressure of needing more resources to address today’s problems. However, we cannot lose sight of the big picture – consumers are tired of paying so much for healthcare. We owe it to not just be better, but, to be crude, cheaper. People are uninsured, people go bankrupt from healthcare and ask any employer, healthcare is a big-ticket cost to run the business. We need to keep finding ways to take money out of the system – it is our societal duty.

  1. Innovation doesn’t trump improvement

When we know there are processes and systems that don’t work well, we look to innovation (or sometimes we go further to disruptive innovation) to try and improve what we are doing. However, I would suggest that improvement is a tried and true best practice that we need to proliferate. This isn’t about one or the other, but we need to realize that until we get to a big, innovative change, people are suffering. Improvement, done in rapid cycles, with the discipline of testing and learning, and focusing on data, should be a core leadership competency. We owe it to those we serve to keep getting better.

  1. Pilot often, deploy quickly

We are great at starting pilot projects in healthcare because we are learners and trying to do better for those we serve. Pilots, though, tend to linger. It is hard to stop a pilot because it is not working (remember we often start pilot projects based on a hope that they would work). So, we need to be more thoughtful in having the measures to know if a pilot worked or not and make decisions rapidly to stop them or deploy them. Going from one, to a few, to all, is our deployment opportunity. Let’s learn or fail quickly. And when we know a pilot works, let’s get it out faster.

  1. Strategy sells, but execution closes

In baseball, the starting pitcher can strikeout the first six batters or go six shutout innings and be a star. However, the closer still needs to finish the game to get a win. Otherwise, the team could lose and the efforts of the starter will go unrealized in the stat books. Execution can be thought of as the “closer” in healthcare’s version of baseball (and today in baseball the closer often goes much longer than the starter, or the opener). We are great in developing strategies, but we should be better in executing on them. Of the thousands of healthcare delivery organizations in the country, I am confident that all have a strategy to provide great care (high patient satisfaction) or great medical outcomes (no patient harm), but how they achieve that is about execution. Don’t lose your respective game because you don’t consider the value of the closer.

  1. Culture still eats strategy for lunch every day

It all matters, but what really matters – organizational culture! Why we do certain things and how we get them done is the DNA of every organization. As leaders, it is our privilege to set the tone of your desired culture. You can define what you want and then set out on a multi-year plan with a team to strive for it. Hard to quantify in numbers, but it will have the greatest impact on your success and the people you serve.

The healthcare field is fraught with challenges and pressures. But it is a joy and an honor to work in a field that is dedicated to making a difference in people’s lives every day. From seeing a child with a broken hand in the emergency room, to visiting someone in their home for their follow-up therapy, to providing food to someone in need, we truly get to see it all in healthcare. With that as the backdrop, this top ten list of must do’s can be our energy to work with our teams to improve the outcomes that matter to each person.

Maulik Joshi, DrPH

President and CEO, Meritus Health
President, Proposed Meritus School of Osteopathic Medicine