3 things US medicine can learn from Doctors Without Borders

On any given day, Doctors Without Borders (Medecins Sans Frontieres) stations up to 30,000 doctors, nurses and other volunteer personnel in more than 60 countries. In recognition of its pioneering efforts across several continents, the nonprofit was awarded the Nobel Peace Prize in 1999.

Meanwhile the United States is suffering a major health crisis. Tens of millions of Americans live without health insurance while the uncertain future of healthcare policy threatens the coverage and well-being of millions more. Hundreds of thousands of patients die each year from avoidable medical errors, preventable diseases and unnecessary complications from chronic illness. Our medical technology is outdated, our drug prices continue to skyrocket, and our physicians have become so frustrated that most (58 percent) would discourage their children from pursuing a career in medicine.

I am optimistic that our problems can be solved. To that end, I believe Doctors Without Borders can teach us three valuable lessons.

  1. The Power of Mission. On volunteer trips, physicians work 14 to 16 hours each day, often in scorching heat and without pay. Upon returning home, they almost never mentioned the travails. Instead, they spoke of the camaraderie, their sense of purpose, and the memories they will cherish for the rest of their lives. Compared to working in hot, dirty and under-resourced environments, you’d think the American medical office – with its air conditioning and running water – would feel like a vacation. Surveys demonstrate the opposite. One-third of doctors are dissatisfied with their work. Many describe being depressed. They lament all the time spent filling out forms, the isolation of working alone, and their frequent battles with health plans over prior-approvals and reimbursements. Unless physicians can reconnect with the fundamental purpose of their profession – helping patients – the cynicism and “burnout” afflicting doctors today will only worsen. Understanding how Doctors Without Borders has revived and nurtured this sense of purpose in its physician volunteers would be a great place for our country to start.
  2. The Essentials of Organization. Inefficiencies in U.S. medical centers have become the norm. The failings of U.S. healthcare – namely, its high costs and under-performance – aren’t the result of flawed doctors, nurses and staff. They’re the consequences of a broken delivery system, one that lacks operational efficiency and clinical effectiveness. Relief organizations like Doctors Without Borders place great importance on getting the right support in the right place at the right time. If our nation did the same, we could raise clinical quality and make health coverage more affordable for all.
  3. The Importance of Clarity. During volunteer endeavors, all doctors understand what they are doing and why. To a person, the goal is clear: Save as many human lives as possible. It’s hard to imagine a clearer “metric.” We may want to believe the U.S. healthcare system is designed to maximize the lives saved. But if that were true, we would not trail the 10 other wealthiest nations in health outcomes – not when we spend 18 percent of our GDP ($3 trillion annually) on healthcare.

Doctors Without Borders, and its tens of thousands of volunteers, has much to teach American medicine. … I hope my donations to Doctors Without Borders will serve as an investment in the health and medical education of both our country and our planet.

[Excerpts of Forbes article by Dr. Robert Pearl, a clinical professor of surgery at Stanford University]

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