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RESOURCES - Leadership Guide

Section 2 - Overview - A System in Need of Critical Care

Tess Blackwelder having her blood sugar checked - Cincinnati, Ohio

The U.S. health care system is in crisis. We spend over a trillion dollars on our health care each year. As much as a third of those dollars is wasted, either by not helping patients or, even worse, harming them. No individual, rich or poor, is immune to the shortcomings of American medicine. Business-as-usual in our health care system is simply not acceptable. So what can we do differently? What can we do better? What can we fundamentally change?

The answers to these and many other questions will be explored in Remaking American Medicine…Health Care for the 21st Century, which takes an approach that does not seek to assign blame, but to call attention to solutions.

In the series, we'll see how families, patients, physicians, educators, administrators, consumer advocates and policy-makers are addressing the problems that plague our health care system.

Through their stories, struggles, ideas and innovations, the series seeks to inspire not just health care providers, but the patients they serve, to work together to change fundamentally the quality of American health care for the better.







Remaking American Medicine demonstrates:

  • A system that is struggling to determine what isn't working and why.

  • A system that respects the individuality, values and culture of its patients. One in which informed patients are able to take more control over their health care decisions. 

  • A system that embraces the rapid advance of digital technology.

  • A system in which treatment decisions are formed by the latest scientific and clinical evidence.

  • A system in which the dedication of resources toward quality of medical care is considered a wise investment.

  • A system in which cooperation and coordination are valued.

The change that is taking place is revolutionary. It comes from the bottom up and the top down. Consumer advocates, policy-makers and the business community are beginning to demand that the practice of medicine be fundamentally transformed to become more accountable for safety and quality. Growing numbers of those within health care are making the same plea. At the same time, many medical practitioners, administrators and experts in quality improvement have begun a series of dramatic, even breathtaking, changes in their work practices, systems and institutions.

The greatest enemy to quality health care is indifference. Remaking American Medicine is a wake-up call. It can serve as a rallying point in the effort to change the way health care is delivered - and received - in our country. The revolution has begun. Now we must help move it forward.


"We envision a system of care in which those who give care can boast

about their work, and those who receive care can feel total trust

and confidence in the care they are receiving."

-- Donald M. Berwick, MD, president and CEO

Institute for Healthcare Improvement

























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