It's now year 2 of the once-in-a-century pandemic. Millions of Americans have now been vaccinated. The rate of infections and mortality is slowing.
Healthcare professionals are celebrating cautiously. In a by the Kaiser Family Foundation and the Washington Post, 76% of the respondents said they feel "hopeful" when going to work now. And two-thirds reported feeling "optimistic."
Are their sentiments foolishly premature? If we were able to ask one high-achieving, would-be politician and Vietnam War veteran, the answer would probably be yes -- but not so fast. Be careful. Take care not to overdose on optimism.
Take the case of this man: Little in his youth suggested he would later in life become heralded as a worker's philosopher. Before entering the military, he had enrolled in 1959 at Stanford University as a graduate student in international relations and comparative Marxist thought. He was bright enough to have finished in the top quintile of his college graduating class and to have once tutored future astronaut John Glenn in physics and mathematics.
After leaving Stanford, rather than pursuing a career in academia, he joined the Navy and entered pilot training school. On Sept. 9, 1965, he was shot down on a mission over North Vietnam and parachuted into a small village, where he was captured and severely beaten.
He spent the next 7 years as a prisoner of war. His Viet Cong captors tortured him routinely until releasing him in 1973 as part of the Paris Peace Accords.
Nearly 20 years later, as a retired admiral and vice-presidential candidate, he famously opened a nationally televised debate by asking, "Who am I? Why am I here?"
That man was James Bond Stockdale, whom 1992 presidential candidate Ross Perot selected as his running mate. While older Americans may remember the late admiral for his opening debate blunder, fewer may also recall his stock response to repeated questions about why fellow POWs didn't make it out of the Hanoi Hilton. He would say: "Oh, that's easy; they were the optimists."
The optimists were the POWs who said, "We're going to be out by Christmas." And Christmas would come and go. Then they'd say, 'We'll be out by Easter.' And Easter would pass, then Thanksgiving, and then it would be Christmas again.
"The optimists died of a broken heart," Stockdale said. The survivors, he said, prevailed by marshaling "the discipline to confront the most brutal facts of your current situation, whatever they might be."
This philosophical approach has become known as the Stockdale Paradox. The basic idea is to find the proper balance of optimism and realism. This paradox laid the foundation for a style of leadership that not only enabled survival but also won Stockdale the Medal of Honor from President Gerald Ford.
Let there be no doubt that the current pandemic has dealt the healthcare profession the most brutal of facts. In early 2020, COVID deaths rose from zero to tens of thousands in weeks. We heard in March 2020 that the virus would "disappear soon." A few weeks later, as case numbers exploded, the message was that the virus couldn't survive warmer months, and then we could return to normal. As the national election drew nearer, word was that the vaccine was just around the corner.
The truth is that none of this materialized – with one exception, when vaccinations became available after the election. Meanwhile, more Americans have died from the coronavirus than perished in World War II.
We keep hearing and hoping that American healthcare will soon be back to normal. But normal doesn't come. Instead, we might consider applying the Stockdale Paradox and resist attempts to predict the future, and to instead take action in the present while remaining cautiously optimistic about what lies ahead.
For example:
- Accept that telemedicine is here to stay. Because other pandemics will come, we should get comfortable caring for patients without touching or examining them at every encounter
- Retool the practice of medicine to offer more immediate access to new patients. A common patient complaint is having to wait for weeks or months for appointments. For many of us providers, we can reduce delays by reserving one or two slots daily for new patients or those with urgencies
- Develop an on-time policy for the practice and see patients within 15 minutes of their designated appointments. To be sure, it may take significant effort and team involvement, but it's almost always easier than you might think, especially through altering the scheduling process
- Return all calls and emails to patients, ideally within 24 hours. Every patient reaching out through text messaging, email, or a phone call deserves a response within a day -- 2 days at most. Again, it may take creative thinking and some responsibility and work reorganization, but it's far from impossible
- Focus on creating positive patient experiences at each interaction with the practice. A good starting point is conducting an online patient survey (such as from SurveyMonkey.com) and identifying what patients like. Then provide more of what they appreciate and address what they don't like
- Shift as many hospital and around-the-clock procedures to the office as reasonably possible -- providers and staff are more in control and more efficient working in their offices
None of us knows what's next in healthcare with, one exception: no matter what, things will never be quite the same as before. It's always been that way. Change is truly the only constant. The choice is simple. We either make changes in response to a crisis or we struggle with the old ways out of habit and suffer the consequences.
So how do we not merely survive but catapult ourselves and our careers forward while the pandemic drags on? Taking a cue from the admiral's paradox, we should discipline ourselves to confront the most brutal facts before us.
And we accept that we cannot go backward -- only forward.
, is a physician in New Orleans, corporate medical officer of Vanguard Communications, and co-editor of .