Health Policy

GoodWill’s Lessons for Health Care


The New York Times had an interesting profile this weekend about how Goodwill Industries is trying to revamp its online presence – transitioning from its legacy to a new platform GoodwillFinds — in the amidst of numerous other online resellers.  It zeroed in on the key distinction Goodwill has:

But Goodwill isn’t doing this just because it wants to move into the 21st century. More than 130,000 people work across the organization, while two million people received assistance last year through its programs, which include career navigation and skills training. Those opportunities are funded through the sales of donated items.

Moreover, the article continued: “Last year, Goodwill helped nearly 180,000 people through its job services.” 

In case you weren’t aware, Goodwill has long had a mission of hiring people who otherwise face barriers to employment, such as veterans, those who lack job experience or educational qualifications, or have handicaps.  As it says in its mission statement, it “works to enhance the dignity and quality of life of individuals and families by strengthening communities, eliminating barriers to opportunity, and helping people in need reach their full potential through learning and the power of work.”

As PYMNTS wrote earlier this month: “Every purchase made through GoodwillFinds initiates a chain reaction, providing job training, resume assistance, financial education, and essential services to individuals in need within the community where the item was contributed.” 

I want healthcare to have that kind of commitment to patients.

Healthcare claims to be all about patients. You won’t find many that openly talk about profits or return on equity. Reading mission statements of healthcare organizations yield the kinds of pronouncements one might expect.  A not-entirely random sample:

Cleveland Clinic: “to be the best place for care anywhere and the best place to work in healthcare.”

HCA: “committed to the care and improvement of human life…dedicated to giving people a healthier tomorrow.”

Kaiser Permanente: “to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve.”

United Healthcare: “to help people live healthier lives and make the health system work better for everyone.”

UPMC: “Serve our communities by providing outstanding patient care.” 

There’s a lot about care, some about health more generally, but not so much about helping people reach their full potential.  That’s someone else’s job, some other organizations’ missions. That seems like something important that’s missing.

One of the things I’ve valued about Twitter – er, make that “X” – is getting to know more in the health community, or rather, communities. One of those that has been mostly rewarding is learning more about the people whose experiences in the healthcare system has made them vigorous advocates for patients – themselves and others.

At the risk of overlooking many worthy efforts, they do things like fight for patient information privacy, access to one’s own health data,  helping patients navigate the healthcare system, ensure patients are represented in clinical trial design and in healthcare conferences, and empowering peer to peer health.  I’m leaving many others out; the breadth and scope of, and passion for, their efforts are breathtaking

Too often, in the healthcare system, patients are people to whom things are done. They may – although not always – be in their “best interest,” but they have not generally been true partners.  Making their lives, not just their health, better has not been the mission.  Involving them, asking them, deferring to them – no, that’s not the tradition.

When your healthcare conference has panels of “experts” that don’t include the people getting care, it’s not about patients. When your board is heavy on clinicians and donors but light on patients, your organization is not about patients.  When your company develops drugs but don’t heavily involve the kinds of people who will be using those drugs, it’s not about patients.

And when your healthcare organization sues former patients or sends them to collection, that’s not about the patients’ best interests.

Here’s where I compare Goodwill to healthcare.  Where are the healthcare organizations that actively seek to hire patients?  Where are the healthcare organizations that recognize that the care some patients received may make resuming their former jobs/lives difficult or impossible, and seek to hire them or retrain them? 

E.g., instead of suing those patients who can’t pay them bills, hire them, so that they can earn a living that allows them to.  Or, at least, help guide them into other jobs that will.

Most healthcare organizations are led by executives with impressive business and/or clinical backgrounds, but I’ll posit this: ones led by people who have experienced, or are currently experiencing, significant health issues of their own would be very different than those that are not.  Personal familiarity with receiving health care should be as much of a prerequisite for healthcare executives as an M.D. or MBA.

Perhaps your healthcare organization has a “patient experience: officer; well, congratulations. But if that person isn’t actually a patient, just having someone in the role merits barely a passing grade. Moreover, there isn’t a singular “patient experience.” A woman with breast cancer has a different experience than, say, a man with a heart condition – or from a man with breast cancer, for that matter.  Getting that “patient experience” right is tough stuff.

Still, we can try to do better.

Now, I don’t want to ignore that Goodwill isn’t some idyllic organization.  It’s been accused to excessive executive compensation, of underpaying disabled workers, or even having unsafe working conditions.  Some of those charges may be misinformation, but it – and Goodwill isn’t really even an “it,” it’s a collection of independent organizations – isn’t perfect.  I just don’t see what healthcare organizations aren’t living in their own glass houses and are in no position to throw any stones. Goodwill has a broader view of making people’s lives better than healthcare organizations do.

I admire Goodwill’s commitment to hiring people whom other organizations don’t, and to helping others to be better prepared to find work elsewhere.  Healthcare organizations too often wash their hands of people once they are no longer “patients.”  They need a more holistic view of the people they serve, and they need more of those people’s perspectives. 

Healthcare – stop thinking of people as simply patients and start treating them as people.