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It's that time of year again.

The start of a new academic year, marked by the arrival of a brand-new class of interns starting out in their training.

Clutching their freshly-minted medical degrees, they appear so ready, so anxious, so excited, so eager to learn.

Now it's our job to make sure they stay this way.

(Have I written this column before? Every year ...)

We need to make sure we have a world where the healthcare system lets them fully engage in their training as well as the care for patients, where the systems don't feel like they set are against them, where the electronic health record isn't an enormous cumbersome beast sitting between them and their patients, where the rules and regulations batter them down and make them want to get the heck out of Dodge.

They are arriving as new trainees, many who have been on a straight-and-narrow path from high school to college pre-med to medical school to residency, and some are coming to us after a variety of diverse careers, bringing a different set of insights and desires for how they want to take on the system and immerse themselves in their training.

We should make it easy.

To transform our healthcare system into a kinder and gentler one in which our patients can safely travel, and our providers can safely train and ultimately practice, we need to redouble our efforts, to find new ways to break away from the entrenched bureaucratic and regulatory barriers that do nothing to improve the care of our patients, and everything to burn out the providers trying their best.

We need to re-energize our troops, reinvigorate our investigators, re-challenge our innovators, across the entire spectrum of the healthcare experience, and fight the good fight to allow us to take back the system so that it once again belongs to those out here taking care of patients.

If we want to change the electronic medical record so that it actually becomes a living, breathing representation of patients as they flow through care, then we should not take no for an answer.

If we want the insurers to stop telling us how to practice medicine, then we should not take no for an answer.

If we want to figure out a way to get our phones answered, then we should not take no for an answer.

If we think that data is bad, and the way we are measuring quality misses the mark, then we should not take no for an answer.

There so many people out there working in the world of health with so many amazing ideas about how to do things better.

My dream is for us all to find better ways to learn about all these new ideas, from care coordination, to community health workers, to universal access to mental health.

We can find better ways to increase health equity, to build a better electronic medical record that isn't just a tool for documentation, to develop new systems to improve shared decision-making between patients and providers, to improve telemedicine, to use artificial intelligence that makes sense for how we do things, and so many things that have the potential to add value and not just more work.

If we can't do this, we're destined to continue rolling down the path we're on, continuing to function in this system so perfectly designed to get the crummy healthcare out of it that we are presently getting.

Our patients, and our country as a whole, deserve better.

And our trainees, those who are arriving now so excited about entering a field they are privileged to join, one that allows them to enter into this unique and special relationship with patients to get them healthy, deserve better.

Let's commit to doubling down on our efforts to make a difference, to see these things through, to accept nothing but the best for our patients, our trainees, and the healthcare system as a whole.

We are never going to get everything we want, and the road ahead will certainly be covered with landmines and potholes and barbed wire trying to keep us from moving forward, but the vision we all share of an idealized patient-centered system that treats our patients fairly, and respects and supports our trainees and providers while holding them to the highest standards and giving them what they need to get the job done, makes the battle worth the fight.

Walking out of the office this afternoon to grab a cup of coffee between conferences and meetings, I was passed by a small cluster of the current year's interns (poised to become junior residents) walking back to the office for their afternoon practice session, and the snippet of conversation I caught was " ... spent an hour on the phone getting prior authorization."

We've got to create a world where no one ever needs to utter that phrase ever again.

Never. Ever. Never ever.

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