Never Let a Crisis Go To Waste
I was a junior member of the U.S. Department of the Interior when Rahm Emanuel served as President Obama’s Chief of Staff in the Great Recession. His motto — “You never want a serious crisis to go to waste” — reverberated across the Administration. These words have been ringing in my head now as our country grapples with the need for structural changes in our healthcare system.
Over the past fourteen months, we have experienced job loss, prolonged physical distancing, climate crises and social unrest. But above all, the Covid-19 pandemic has been a major disruptor for global public health. Hundreds of thousands of American lives have been lost, with a disproportionate share being Black and Latino.
The problem I’ve found most troubling is the elevated and persistent rate of mental health illness. In June 2020, the C.D.C. reported that one in four Americans age 18 to 24 had considered suicide in the past thirty days, a rate 2–3x pre-pandemic levels. This past month, roughly one in three Americans overall and an estimated half of young Americans age 18 to 29 reported anxiety or depression symptoms, according to the National Center for Health Statistics.
The pandemic is puncturing the social stigma with mental health, leading more people to seek support. Unfortunately, what’s been exposed is a provider shortage. As the son of a lifelong clinical psychologist, this hits home. Even before the pandemic, with just over 700,000 mental health providers in the U.S., we were struggling to meet rising demand while keeping the cost of care within reach. The patient experience of accessing support has long felt defeating, difficult and disconnected.
May is Mental Health Awareness Month and myriad organizations and leaders have recently shared powerful stories that shine light on conditions including stress, anxiety, and depression. To improve our public health infrastructure, I have founded an enterprise software company called Dr. Katz with the goal of building a better support system for psychiatric care. In this post, I would like to share how and why I got here. I invite you to join me in this journey, because structural change doesn’t happen on its own.
In March 2020, as Covid cases began exceeding 20,000 per day in the U.S., California started implementing one of the nation’s first stay-at-home orders. It was clear that the challenges in our healthcare system were reaching an inflection point.
For seven years, I had built enterprise software applications at Workday. I had developed relationships with wonderful colleagues and customers. But the country was in crisis and I wanted to commit myself fully to help.
Fundamentally, there were two questions I thought we needed answers to:
First, how might we close the gap between people in need and professionals trained to deliver mental health support?
Second, how might we increase access and improve the quality of care, especially for people in disadvantaged, rural and vulnerable communities?
I knew the world was changing quickly. By watching and listening carefully, I hoped to learn where it was going. My approach? Interviewing scores of clinicians and patients. Over Zoom, of course!
Just over one year later, the spread of Covid-19 looms large as a defining moment. But despite not being a clinician myself, mental healthcare has been a constant subject of interest all my life.
As I met folks online and told them about my project and its namesake, people would ask, “So, who is Dr. Katz?” Answering that question brings a smile to my face, as Dr. Elizabeth Katz is my mother. As a clinical psychologist, she has been seeing patients since the 1980s.
Counseling with Dr. Katz, or Betsy, is usually conducted one-on-one, or with a couple or family. Before the pandemic, it would take place in her home office in the Washington, D.C. suburbs. I remember dinner often starting fifteen minutes later than planned, because my mom would never urge a patient to leave.
Since the onset of the pandemic, healthcare technology has advanced the psychiatric field. These changes have included rapid adoption of telemedicine. My mother, for example, has been able to use an iPhone and computer to continue her practice. She experienced a deluge of patient inquiries requesting virtual visits. She wasn’t alone, either.
A recent Massachusetts General Hospital (MGH) study found telemedicine visits for psychiatric services increased from 5% of care before the pandemic to an overwhelming 97% majority within one month. Many in the field are convinced that regulatory relaxations that helped enable expansion are here to stay. They laud shorter, more frequent patient visits, high attendance rates, and increased patient satisfaction.
As pandemic work-from-home life became a “new normal,” I saw my mother not only adjust to remote care delivery, but also video-based continuing education. Her days are full of virtual events and conferences, online patient management, and digitally connecting with peers for referrals, recommendations, and resources. But none of this is well-organized.
I have spoken with hundreds of clinicians at small, medium, and large organizations. One thing has become clear: the patchwork approach to core workflows is failing social workers, nurses, counselors, psychologists, and psychiatrists. The status quo is not getting the job done.
In my conversations, I heard about disconnected applications, band-aid workarounds, and too much time spent managing machines instead of helping humans. I am convinced we can serve these professionals better.
Through business and technology collaboration, I believe there are boundless opportunities to support transformational healthcare experiences for patients, clinicians, and organizations alike.
We cannot let this crisis go to waste. It’s time to build.
