A vision where hospitals advocate, and doctors are closer to their community. Where the leadership and economy of Care have deep community roots.
I find that the most effective healthcare organizations do not function as hospitals, but as community organizations that promote the health and wellbeing of their communities. Our current understanding of hospitals reduces them to institutions of urgent, chronic, or complex patient care. In this understanding, hospitals are self-contained organisms: they do not execute any influence outside of their borders, but react and adjust to what is happening out there — what is bringing patients in. In this understanding, hospitals are organisms of minimizing damage, not resolving endemics.
Yet my vision, and the modern understanding of a healthcare organization, advocates for these organizations to be more involved with other stakeholders — schools, local governments, NGOs serving the community. Alongside applying clinical knowledge to individuals in practice, we get to applying it to systems in community. This ultimately takes the form of preventative, urgent-nonclinical, and community care led by the healthcare providers on the ground.
This all requires independence on many local levels, but healthcare organizations with the autonomy to start community initiatives are certainly a great start.
Historically, the path from clinical findings to policy change hasn't been straight, and doctors have had minimal leadership in pioneering that change: a tragedy occurs, the community is terrified, doctors as the experts testify — not advise — and it's politicians and community leaders who pioneer the change. This has been the case in first-world nations over the last century, and we are far from it here in Iraq. However, I think this independence can create many experiments, and with variety comes more data. The initiatives that succeed in their goals will be celebrated, and professionals will long for more policy innovation — for ultimately fewer patients.