The healthcare ecosystem is highly complex, often leaving patients frustrated with their experiences and sometimes unable to access the care they need when they need it. So what can be done? In the latest episode of the McKinsey on Healthcare podcast, senior partner Drew Ungerman, global leader of McKinsey’s social, healthcare, and public sector entities work and global coleader of the McKinsey Health Institute, shares his thoughts on the intersection of public health and the healthcare industry.
Ungerman sits down with Querida Anderson, McKinsey senior editor for healthcare, to discuss what healthcare leaders need to do to build on the industry’s current foundation and improve healthcare. He suggests three overarching themes: putting patients at the center of care, moving from a “sick care” to a true “health care” industry, and focusing on holistic health to not only increase how long we live but also enhance our quality of life.
In the podcast, Ungerman also talks about leadership strategies, whether during crises or times of significant change or when dealing with the vast variety of uncertainties inherent to healthcare and from macroenvironments. He stresses the importance of building a team with clear roles for employees who focus on near-term challenges versus those who think about hurdles further out on the horizon, noting that it is a leader’s responsibility to seamlessly bring those strategies together. Last, Ungerman offers his insights on how AI and other digital technology could bolster healthcare delivery, while emphasizing the importance of managing risk carefully. He also stresses the need for tech to supplement healthcare workers and give them more opportunities to have much-needed human-to-human interactions.
A lightly edited version of their conversation follows.
Querida Anderson: Drew, you lead McKinsey’s Healthcare Practice as well as the Public Sector Practice. What is your perspective on the intersection of public health and the healthcare industry?
Drew Ungerman: Whether you’re employed in the public sector or the private sector, fundamentally, healthcare is an important human right and something that we all care about deeply. The practice of healthcare involves technology, but ultimately, it’s people taking care of people. The public sector wants people in the United States to be taken care of, and the private sector aims to deliver quality, affordable, and accessible care. So whether you’re coming from the public sector or the private sector, we all want the same thing, which is a good healthcare experience and outstanding outcomes at an affordable price—and with some degree of convenience as well. We’re doing great as a country in many ways, but we also have a lot of opportunities.
How to ensure patients take precedence
Querida Anderson: Let’s talk about those opportunities because it can seem, particularly to people who are not directly involved in healthcare, that public health and how we actually experience healthcare can be at odds with each other. Of course, the healthcare industry is a complex one—and in many ways, understandably so—but still, it’s easy to understand why people are frustrated by that complexity. So what do healthcare leaders need to do to address those concerns and regain or rebuild public trust in the system?
Drew Ungerman: Healthcare is extraordinarily complicated. The human body is complicated, and while healthcare is a science, it is also partly an art. Technology has a role as well. But yes, there are a lot of structural issues when it comes to delivering high-quality healthcare, whether it’s in the United States or globally.
There are three things we need to do to improve on our current foundation. First, we have to put the patient at the center. Too often, we’re focused on structural incentives and who pays for what as opposed to making individuals healthier. So how can we take care of patients in their time of need?
Second, we need to move from a “sick care” industry to a true “health care” industry. The fact is, the setup we have now in the US healthcare industry tends to incentivize folks in the ecosystem to focus more when someone is really sick as opposed to helping people maintain a healthy lifestyle all the time—the 99 percent of the time when they’re not in a healthcare facility.
Third, we need to focus on holistic health. We’ve added 20 years of life over the past several decades, but unfortunately, we’ve made very few strides in improving the quality of life. So as an industry, we need to look at ourselves in the mirror and ask, “How can we improve the quality of life in the same way we’ve extended the years we’re all fortunate enough to have?”
Querida Anderson: Let’s zoom in on that idea of putting the patient at the center of care. What do leaders need to do to achieve that mission?
Drew Ungerman: It starts with how people experience the healthcare system. We have to be honest: Often, when you interact with the healthcare system, you’re not doing it because you want to; you do it because you need to, so it’s not something you do with lots of excitement and energy. You’re vulnerable because you’re not feeling well. So we have to recognize that the experience with healthcare is different from a lot of other industries that we interact with every day. The experience with healthcare is often bad, right? It’s bad in terms of finding access to care at a level of convenience that you expect and experience in the rest of your lives. We have to improve access.
Once you’re able to receive the care you need in a timely fashion and at a high quality, we have to look at how folks are treated. Do they have long wait times? How long does it take to see a clinician? What is the follow-up care that is prescribed, and what follow-up actually happens?
Closing that loop of getting sick, getting better, and maintaining a patient’s health is way too complex right now, so we need to simplify that for consumers. To do that, we have to address some tough issues, but it has been done. There have been hospital systems, payers, and disruptive organizations in Silicon Valley and beyond that have taken pieces of the healthcare experience and made it better, so we know it’s achievable. The challenge for the system as a whole and the individual stakeholders leading it is about scaling those improvements and doing it consistently each and every time.
What it takes to be an effective leader in healthcare
Querida Anderson: Let’s shift to talk about leadership in different scenarios: leadership through crisis, leadership through significant change, and leadership through uncertainty. Starting with leadership in times of crisis, how do stakeholders and leaders think through those situations?
Drew Ungerman: Unfortunately for the healthcare industry, times of crisis are more the norm than not. Of course, COVID-19 challenged the entire world and certainly challenged the front lines of the healthcare industry. With that came extraordinary loss, extraordinary stress, and extraordinary burdens in terms of the loss of life and the people who are still dealing with long COVID in ways that have fundamentally changed their quality of life.
Many leaders learned how to operate at a metabolic rate that was much faster than when they were not in that crisis setting. That meant getting people the care they needed at scale more quickly. That meant greater communication and levels of transparency on what we knew and didn’t know. How we were dealing with that crisis inspired more confidence in the healthcare system at the time.
Responding to COVID-19 brought together disparate parts of the system. Insurers, the government, healthcare providers, physicians, clinical caregivers, and the public were all trying to row in the same direction against a great deal of uncertainty. The pandemic taught us a lot. We now have to bring those learnings, those process changes, and that level of communication and transparency into more-normal environments.
Also, healthcare leaders learned how to better prioritize what really matters and cancel out the additional noise. When there is so much happening in the world, it can be hard to figure out how to prioritize your days, weeks, and months in an efficient way.
Leaders also figured out how to better leverage technology. We have a workforce challenge when it comes to healthcare, both in this country and globally. Technology has been a great way to improve experience and deliver care at home and from other access points more efficiently.
Querida Anderson: How is leading through significant change different?
Drew Ungerman: It’s not very different—it’s just a matter of degree. Healthcare leaders globally need to learn how to adapt to change all the time because it’s happening rapidly. Technology has allowed us to improve many scenarios, including reading radiology results, reducing the time it takes to do a nurse shift change, and better managing our supply chains to substantially reduce inventory and still get the goods and services that our communities need. But it has also required the clinical workforce and everyone involved in healthcare to learn dramatically new skills. It’s not simply continuing education once a year or once every few years; it’s literally adapting and evolving every day. That’s the world we live in. The only thing we know is that the rate of change will never be as slow as it is today, because it’s only going to intensify with technology and some of the challenges.
Querida Anderson: When it comes to leading through uncertainty, it’s tough to plan for what you don’t know. But planning for uncertainty also goes along with the more traditional way of thinking about strategic planning, which is the short term versus the long term. Can you talk about leading through uncertainty as well as the importance of managing different timelines in parallel?
Drew Ungerman: Healthcare leaders today need to learn to operate in at least two-speed environments, if not more. Whether it’s a crisis or just the normal degree of uncertainty that happens every day, you have to manage the daily challenges that come your way. You have to take care of patients you didn’t expect to see. You have to manage workforce challenges. You have to manage your financial resiliency, which has been a significant challenge over the last couple of years. That’s just table stakes.
But that’s not enough. You have to also look over the horizon. Whether there are good opportunities that technology is enabling or systemic challenges, such as climate change, that are imposing greater risk to the population, you have to operate in both environments. And that requires you to have a strategic mindset as a leader. It also requires you to build a team that can operate in a dual-speed environment.
Some people on your team need to be focused on the short term. Others need to look and see what’s around the corner. So as a leader, you need to be clear on who’s doing what and how you are knitting those responsibilities together in a seamless way that doesn’t distract or disrupt your workforce, which is already challenged by a variety of daily obstacles.
Leaders also have to create a structure around the uncertainty. You will never be able to completely resolve all uncertainty. That’s just a pipe dream. But what you can do is plan for that uncertainty. You can create scenarios and practice for some of those crises so when they do occur—and they will—you can run the playbooks you’ve created. Many in the healthcare industry do this extraordinarily well, and other industries can learn from the healthcare industry in that respect.
How AI and other digital technologies can augment healthcare
Querida Anderson: You mentioned the importance of tech in healthcare. AI, in particular, is progressing at the speed of light, and naturally, healthcare needs to approach it with some caution. How do you think about AI and the future of healthcare and AI?
Drew Ungerman: Whether it’s AI or technology more broadly, I think the sky is the limit for technology to improve healthcare outcomes and experiences and address the challenges we talked about earlier. I’m extremely hopeful and optimistic about the role technology will have in improving healthcare globally. But at the same time, as you said, these advancements shouldn’t be taken lightly. At its core, healthcare is people taking care of people often in their most vulnerable moments, and technology can help us do that better. But healthcare is also a highly regulated environment. The first rule for anyone who goes through any clinical training is “do no harm.” So we have to manage risk very carefully when using technology or AI in any aspect of the ecosystem. And we’re learning how to do that even as technology advances rapidly.
Consider that there are clinical aspects of delivering healthcare, administrative aspects, and operational aspects. Technology can improve all those things. For example, on the administrative side, whether it’s the interaction costs between payers and providers or providers and the government, there are a lot of administrative burdens, and technology can help release some of those burdens through automation.
We have workforce shortages in every aspect of healthcare. What role can technology play? Its role is not to take away the job of a nurse or a technician but to supplement them and allow them to spend more time at the bedside to have those human-to-human interactions that are so vital to improving healthcare. And technology can play a great role in reducing shift changes and allowing for a higher degree of accuracy from one nurse to the next as the shift change occurs. There are so many exciting things, such as using tech to help with radiology readings and making sure it supplements the radiologist so it doesn’t take away from human training. It’s a great enabler in that respect.
Operationally, emergency rooms are overburdened in almost every country in the world. Technology can help improve workflows and automate tasks as it has in other industries to allow for a more seamless experience and to help improve some of the consumer challenges we talked about earlier.
Querida Anderson: Last question: If you had a magic wand, how would you wave it to make the healthcare industry and the public health sector better?
Drew Ungerman: I would love to improve access to high-quality care regardless of where someone is born or the means they have. I think that’s critically important. And I hope with technology advancements and with the public and private sectors coming together, we’ll be able to embrace the good innovations that are happening in clinical care, patient experience, and improving access.
And while we’ve extended that quantity of life for many, let’s be honest: Depending on what zip code you live in, that’s not even true. So the first thing I’d like to do is to extend the same opportunities to live a long and full life to everybody, regardless of where they live. And I do hope we can address quality of life as well. That’s where the healthcare industry can help: in looking at factors such as chronic disease management, fitness, food and nutrition, and housing security—because all those things are equally important to ensuring we can all live in a healthier world tomorrow.
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