Do You Want to be Healed?

As a physician, there’s a story in the Christian tradition that has intrigued me for a long time. To me, it speaks to the difficulty of moving out of the status quo, however uncomfortable or distasteful the current situation may be. I used to consider this concept when treating chronically ill patients. However, I now think of this story more in the context of our ailing healthcare delivery industry, especially with health systems and physicians.

Here’s a summary of the story:

There was a pool on the edge of Jerusalem where the sick and afflicted gathered in hopes of a healing experience. It was said that, on occasion, an angel would stir (or disrupt) the water. When this happened, the first one to get into the pool would be healed. People laid and sat by the pool for years in hopes of seeing the stirring and being the first one in to reap the reward. For many, the healing never came.

Jesus and his followers went to this pool one day. They found a man there who had been ill and afflicted (an “invalid” in some versions of the story) for 38 years. He had been sitting by the pool every day for some undisclosed number of years, but clearly for a long time. By the time he arrives on this scene, Jesus was already a well-known miracle worker and healer. He went to the man and asked a question.

It is this question that has intrigued me all these years.

“Do you want to be healed?”

Spoiler alert, Jesus goes on to heal the man. But let’s focus a bit on this question. “Do you want to be healed?”

This fellow had been ill 38 years. He had been lying next to a pool that promised healing for several years, hoping and praying for a stir in the waters. Was his wish to be healed not obvious? He either made his way to the pool every day, or he just lived there, waiting for the water to move. He relied on what others would give to him so he could survive and get on to the next day. In fact, at that point in his life, survival was likely his greatest motivation. His hopes had been buoyed by the occasions when the pool water stirred, and someone else was healed.

So, what was the man’s answer to Jesus’ question about his desire to be healed?

It was NOT a resounding answer in the affirmative you might have expected. As the story goes, he instead made excuses. His answer to the pointed question was, “I have no one to help me into the pool when the water is stirred. While I am trying to get in, someone else goes down ahead of me.”

To me, this answer represents a forgotten vision and a complacent acceptance of the status quo’s familiarity – a relative comfort in his discomfort. We sometimes choose to accept an unpleasant current state rather than move to the unknown of what might be better. We feel secure where we are today, pain and all. We’ve learned to work with these circumstances and get through. “Better the devil you know,” as the saying goes. There’s a sense of safety in the status quo. Safety, though, always comes with sacrifice, justification, and rationalization.

I’ve watched health systems and physicians in this same struggle. They sit in their own version of the dysfunction of our healthcare system. They claim to want a healing and a system within which they can flourish. They have seen numerous examples over the years of someone else getting “financially healed” in the industry. Others were quick to seize early on the opportunities of a disruptor – OB care, cardiac care, neurosurgery, orthopedics, vascular interventions, aesthetics, etc. – and their woes were apparently side-stepped enough to enable survival for a little bit longer. That’s the motivation to sit by the pool and hang on, to survive.

We slog through our days in healthcare, waiting for the pool to stir or someone to disrupt it. Surely, our day will come if we just keep sitting by the side of that pool, survive to the next day, and wait for our golden opportunity.

In the meantime, we answer the questions about whether we want things to be different or better by making excuses. If only the insurance companies paid more … if only the patients would take better care of themselves … if only the labor market were better … if only the malpractice attorneys didn’t make it so that I must see six more patients a day just to afford coverage … if only I had more time. How can I spend more time and attention on patients when what I need to do is run more through the doors?

We know the current system is failing, but we defend our role in it with excuses, rationalization, and justification.

We want a healing within the parameters of our dysfunctional comfort zone.

We have become comfortable and complacent in our current dysfunctional state. We accept this poorly designed system and all the negative it brings to us and our patients. We have learned how to code and keep heads in beds. Our hope is that some stirring will happen, and we’ll be able to get the benefit. If we don’t have to change too much, that is.

Like the lame man spending his days at the side of the healing pool, whose life had so much more to offer once he was healed, we hold on to our current state, wrap ourselves in our defensive excuses, and miss out on the vibrant and whole future that could be healthcare in the US with a healthier, more sustainable system.

More importantly, our patients miss out.

I’ve sat at boardroom tables with health system and physician leaders. They recognize their organizations’ current poor health, but instead of looking for a new path that can change the rules and the barriers of their success, they focus on the external forces that prevent their current success, and they long for a solution that can fit within the current toxic environment. We need to be honest with ourselves. Do we want a healing or just a way to survive to the next day?

Until a miraculous healer came along, the lame man likely did not have other options. The healthcare industry, though, has options – good, strong, viable options that can lead us out of the current dysfunctional state. It takes effort and vision on our part, though, to move from our current comfort with our own discomfort into different settings like value-based care, direct primary care, or full-risk contracting.

Now, please don’t think I’m suggesting any of these options are miraculous. I do they think can play a role in the healing of our healthcare system, but I wouldn’t go so far as to hold them up as messianic. They are, however, workable, sustainable options to our status quo.

A successful shift in organizational mindset takes vision, communication, and effort. But with that effort comes the benefit of a healthier, more functional, and more effective system of care delivery. One that can both sustain the providers of care and optimize the health and well-being of the patients we serve.

So, do we want to be healed?