Thinking Big About How to Fix our Health Care System

Clare Landefeld, MD

BWH Internal Medicine Resident

PGY2

01/29/2020

Clare Chren Landefeld, MD 

I am training in General Medicine, and more specifically Primary Care, because I am struck at how broken our health care system is, and I feel pulled to work on the front lines. So much of my clinical work as a resident feels like putting bandaids on problems, treating clinical manifestations of upstream factors. It has become clear to me that the work needed to address these upstream factors is not valued in our health care system.

With this background, I was so grateful for the opportunity to participate in the 3 day course, Value-Based Health Care Delivery at Harvard Business School. Even in preparing for the course and reading fascinating cases of health care systems across the country and world, I felt like I was learning a new language, and like I finally had a framework with which to conceptualize possible ways forward.

The course itself did not disappoint; leaving the harried but familiar world of the hospital and entering a new campus felt refreshing and like an invitation to think differently from my typical mental pathways of diagnoses and treatments. Meeting my fellow trainees from all specialties and hearing their perspectives on these complex issues was also an unexpected highlight – we have few opportunities to gather as trainees and learn from each other. And then there were the cases; each one thoughtfully designed to bring out key points in a curriculum on Value-Based Health Care.

I left each day with more questions and ideas than I have had in a long time. I left with a renewed sense of purpose, and a sense of empowerment; topics and ideas that previously felt intimidating now felt accessible. I feel empowered to work to bring value to Primary Care settings, and am eager to continue learning more.