Katie Owens - Healthcare Speaker and Executive Coach

Lead Author, The HCAHPS Imperative for Patient-Centered Excellence

Urgency to repeal the Affordable Care Act: an amygdala hijack?

How healthcare leaders can stay focused

I have worked in healthcare for nearly 20 years, from the bedside to various leadership roles. Today, people are receiving care across America’s hospitals and health systems. They are going through the most gut-wrenching situations anyone can imagine or experiencing anxiety that can accompany even the most joyful circumstances. For these individual’s, their sole line of support are the nurses, physicians and staff treating and caring for them at the bedside (and by degrees of separation the leaders who guide the organization).

Repealing the Affordable Care Act without a better replacement feels like a decision driven by an amygdala hijack (when our caveman/woman brain takes over in an immediate visceral response that is blown out of proportion and we lose self-control) versus an approach that carefully and respectfully considers the impact on our citizens.

As JoAnn Volk so eloquently articulates in the January Health Affairs blog, an immediate repeal of the Affordable Care Act would impact immediately 22.5 million people (who are mothers, fathers, sons and daughters), jeopardize access to preventative services, ability for anyone who has a pre-existing condition to receive healthcare (e.g., you need to switch insurance and you have type 2 diabetes or persistent back pain and become out of luck), dependent coverage to age 26 (our children who are getting a start in life), the annual out of pocket and lifetime limits (that caps our risk and ability to secure our families economically) and external review for quality control.

It is undeniable that the task of reforming American healthcare is wrought with multiple stakeholder groups from insurers, providers, patients, pharmaceuticals and more. The writing is on the wall that we are heading into another round of significant industry changes. My hope is that we proceed with a thoughtful approach that acknowledges the complexity and magnitude of what is at stake. For leaders, as we head into uncertainty, it is more important than ever before to keep our teams focused on what they can make a direct impact on; the quality of care provided each day. It is so easy to become distracted when healthcare is the headline and the center of a political hurricane.

Healthcare employees want to make a difference. They have been called to our profession out of a sense of purpose. Each day we are fiercely working to improve quality and assure patients have the best experiences under our care. Much emphasis to improve has come from value-based purchasing and the HCAHPS program in particular. Yet, it occurred to me recently that government should have never had to enforce compassionate care. Yet, we still live in a country where only 71% of patients can say they received care at the best possible hospital. Seventy-one percent is not good enough. Every patient deserves the best care possible.

As we head into another round of legislative actions to create a next generation model, can we collectively hit the pause button and stop pointing fingers and start empathizing with one another? Put ourselves in the shoes of administrators and vice versa where administrators put themselves in the shoes of front line caregivers. And for goodness sake, let’s all put ourselves in the crutches, slippers and gowns of our patients. Maybe then we can step back and gain perspective that as human beings we all deserve compassion and care from our healthcare providers and each other. Let’s create more joy and connection to purpose each day. I bet we will all feel better when our day and shift ends.

To help your organization to remain focused and engaged, contact Katie to speak at your next event.


  1. It seems that the entire world especially those using social media have had an “amygdala hijack” it is difficult to respond to “friends” of twenty years or mentors or experts we respect of many years when the rhetoric and emotions are sooo highly exaggerated , what are some words or actions you suggest to defuse or bring back the other side of the brain when the people we deal with each and every day raise their voices and their blood pressure when discussing ACA? TY

    • Katie Owens

      January 24, 2017 at 1:29 pm

      Build organizational identity and confidence that despite distractions our goals remain to provide the very best care. Leverage your values, standards of behavior and rounding to create ongoing cues of focus.

      It is more important than ever before to be intentional about messaging given the current environment. We recommend senior teams develop messages ( or elevator speech) that answer four questions.
      1- what is it?
      2- why is it important?
      3- what will success look like?
      4- what do you need someone to do?

      Take time to assure your leadership ranks are in alignment with your messages and plans. Consider involving staff to volunteer non-negotiable words or behaviors that serve as distractors to staying focused. Ask for shared ownership in supporting each other and pulling each other back when negativity creeps in.

  2. Thank you for this thoughtful and thought-provoking blog! We have much work to do to ensure we create a world guided by empathy, for our patients, our employees, and our loved ones. Stopping to think (and to breathe) will help us all to make better decisions in this new and uncharted world.

Leave a Reply

Your email address will not be published.