Rural Health

Five Questions

A conversation with Patrick Lee

You’ve written that the quote “the secret of quality is love” has meaning for you. Can you explain why?

Patrick Lee
affiliate, Department of Global Health and Social Medicine in the Blavatnik Institute at HMS; assistant professor of medicine, Beth Israel Deaconess Medical Center; chief performance improvement officer, Lynn Community Health Center, Lynn, Massachusetts

It’s a quote from Avedis Donabedian, who many consider the founder of quality improvement and outcomes research in health care. And it’s an idea that guides me in everything I do. When we take the time to understand what matters to each of us, why we care about each other, and why we care about this problem, we strengthen trust and shared purpose. Teams learn and perform much better under these conditions, and quality improves.

You talk often about fostering respect and dignity in health care. How do you put this into practice?

At our clinic in Lynn, we follow the tenet that we’re here to increase the dignity and respect in each person’s life. I learned this way of working in my first job out of residency, with Partners In Health in Rwanda. It’s the language I’ve tried to use in every job I’ve had. 

If I want to make a difference in the justice and health that people experience through the care they receive, then this is the most effective way I know of to do that.

To what do you credit your ability, your openness to absorb this kind of approach?

My mom, in particular, allowed me to understand that no matter what, she would be there for me if I needed her. I understood, at a deeper level than language, that I was worthy of love.

Both my mom’s parents died from cancer. My grandmother chose hospice care rather than dying in a hospital, but she still endured great suffering. When she passed, my mom said, “If you do go into medicine, I want you to think about dignity, because I’m not sure that the health system has fully understood that yet.”

You’ve talked about “purpose power.” How does this work in practice?

In many of our workplaces there is a deep river of purpose that we don’t take the time to recognize or harness.

In Lynn, we spend three out of four staff meetings doing workflow design and development. We’re in what we call systole, when the heart squeezes and pushes blood through the body. In the fourth meeting, we get to diastole, where the heart relaxes and nourishes itself. We share meaningful stories from our work and take time to learn from our experience. I believe diastole is the most important meeting we have.

How do you think about your work within the current health care landscape in our country?

Poor and disabled people have been left behind in communities across the country, accessing care too late when disease is already advanced, often in emergency rooms and hospitals, and at enormous cost. We’ve known for decades that community health centers are an effective solution to this problem. That’s why they have consistently had strong bipartisan support—it’s both the right and practical thing to do.

Image: John Soares