What I Needed to Know…


… I learned at the reunion.

In September 2014, my wife and I returned to Ohio for our 45th high school reunion.

Reunions provide a time for reflection. I had just resigned my job as Chief Medical Officer for a  hospital and faced one of those crossroads in life. I was contemplating three options:

  1. Work for a company I could get excited about,
  2. Retire, work on my golf game, and spend more time with the family, or
  3. Found a startup that focuses on reversing the dilemma of America’s high cost but relatively poor health outcomes.

My crystal ball was a bit murky –

  1. There wasn’t a company I knew of that I was excited about joining,
  2. It seemed too early to retire, and
  3. The risks of a startup were far outside my comfort zone.

My career as a physician had been rewarding and the practice of oncology was a good fit for me. I felt quite honored to be part of the lives of people who were facing cancer.

However, soon after starting practice in 1982, I became acutely aware of the many challenges facing the healthcare system. Hoping to make a difference, I took a sabbatical from clinical practice in 1987 and immersed myself in building and implementing novel approaches to managing care. However, both of the two regional companies I worked for were purchased by larger companies and the innovations that we had created disappeared.

After over 10 years on the business side, I missed patient care and started a second oncology fellowship to refresh my clinical skills. I found practice just as rewarding the second time around.

But by 2002, when I once again began caring for patients, it was even more evident that healthcare was failing than it had been in the 1980’s. (Read Steve Brill’s comprehensive Huffington Post article, America’s Most Admired Lawbreaker1 to grasp the extent of my concerns.) My stint in hospital administration from 2012 to 2014 changed my perspective. No longer did I believe that fixing healthcare from within the status quo was possible.


Then we went to the reunion. Port Clinton, Ohio was a great place to grow up. Although most of our class went to college, in 1969 the area’s job market for high school grads was still pretty good. (To get an insightful sociological perspective on our town as a paradigm for the change in America over the last forty years, I suggest reading Harvard Professor Robert Putnam’s book, Our Kids: The American Dream in Crisis.2 that focuses on Port Clinton.)

As we mingled at the reunion, the topics included kids, marriages, careers, and healthcare. This wasn’t random; they knew I was a captive physician that couldn’t charge for an office visit.

After the initial interchanges, I started broaching the topic with, “It seems everybody I’ve talked with has a family horror story about healthcare. Do you?” Everyone did.

The answers to this unscientific polling could be sorted into four areas:

  1. Financial hardships from extensive medical bills,
  2. Exhaustive caretaker duties for incapacitated family members – most often with Alzheimer’s disease,
  3. Family disruption from relatives hooked on opioids, antidepressants, alcohol, or street drugs, and
  4. The incredible difficulty of working within the complexities of the medical system.

My classmates were not complaining so much as just sharing their challenging lives. The statistics support their stories:

  • In 2013 nearly 650,000 bankruptcies in the U.S. were related to medical bills.3
  • 15 million friends and family provide approximately $230 billion of uncompensated care for people incapacitated with Alzheimer’s disease.4
  • Ohio is at the epicenter of the opioid epidemic5.
  • Alcohol abuse,6 our “forgotten epidemic”, kills an estimated 88,000 per year.

The stark reality of my classmates’ challenges made a big impact and it wasn’t possible for me to ignore their distress.

I left the reunion knowing that my retirement was somewhere far off in the future. Six months later we founded Switch Healthcare.

Breakthrough To Better,

1America’s Most Admired Lawbreaker
2Our Kids: The American Dream in Crisis
3Bankruptcies due to medical bills
4Alzheimer’s Facts
5Profiting from the Opioid Epidemic
6Alcohol Facts and Statistics


Switch Conversations is a bi-weekly blog exclusively for designated key employers.




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Edition 1 – Solving a Well-Entrenched Problem
Edition 2 – A Case of Dr. Jekyll and Mr. Hyde
Edition 3 – Best marketing tagline of all time?
Edition 4 – Post-Truth Killed a President
Edition 5 – What’s an employer to do?
Edition 6 – Profiting From the Opioid Epidemic
Edition 7 – The Keys to Unlocking Better Decisions
Edition 8 – When Difficult Things Need to be Done Well
Edition 9 – Fixing Healthcare
Edition 10 – Beware of a Singing Cow
Edition 11 – Wise Reflections
Edition 12 – Warning: Reader Discretion Advised
Edition 13 – Can AI save healthcare? (Part 1)
Edition 14 – Can AI save healthcare? (Part 2)
Edition 15 – Can AI save healthcare? (Part 3)
Edition 16 – Embracing Reality to Improve Healthcare
Edition 17 – Everything I Needed To Know…
Edition 18 – The Eighth Circle of Hell
Edition 19 – So… What’s Our Solution
Edition 20 – Protecting Integrity as a Core Strategy
Edition 21 – An Unadorned Legacy
Edition 22 – Time to Grow Up
Edition 23 – Against All Odds
Edition 24 – When Everyone Has Stopped Listening
Edition 25 – Focusing on What’s Important
Edition 26 – Don’t Give Up Your Shot
Edition 27 – Join the Goodhood
Edition 28 – Fixing Healthcare (Recycled)
Edition 29 – Taming the Healthcare Beast
Edition 30 – Leadership
Edition 31 – Better Health Requires Good Sense
Edition 32 – Little Decisions With Big Consequences
Edition 33 – Transformational Courage
Edition 34 – Transformational Courage – Part 2
Guest Post – Happy Thanksgiving! By Jeff Novick, RD
Edition 35 – Transformational Courage – Part 3

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