Wednesday, July 22, 2026

A Child Waited 8 Years for a Heart. Most Clinics Wait 60 Days to Get Paid. Both Reveal the Same Healthcare Problem.

 


"One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient." — Francis W. Peabody, MD, The Care of the Patient, Journal of the American Medical Association (JAMA), March 19, 1927.


Healthcare Doesn't Have a Technology Problem. It Has a Friction Problem.

That statement will probably irritate some people.

Good.

Because most of healthcare is trying to solve the wrong problem.

Last week, healthcare media was filled with stories about AI, automation, digital transformation, reimbursement changes, and the next generation of healthcare technology.

Then a different story appeared.

A 9-year-old boy named Dáithí Mac Gabhann finally received a heart transplant after waiting eight years.

Eight years.

While healthcare executives debate dashboards and AI roadmaps, one family spent nearly a decade waiting for a phone call that would determine their son's future.

The story is emotional.

But it is also instructive.

Because hidden inside this transplant story is a lesson most healthcare leaders completely miss.

The biggest problem in healthcare is rarely lack of innovation.

The biggest problem is friction.


The Contrarian Truth Nobody Wants to Admit

Healthcare leaders love talking about breakthroughs.

Patients experience bottlenecks.

Investors celebrate innovation.

Physicians fight workflows.

Executives buy software.

Staff members re-enter the same information three times.

Everyone talks about transformation.

Nobody talks about friction.

Yet friction quietly determines outcomes every single day.

The transplant system depends on reducing friction between:

  • Donors
  • Families
  • Hospitals
  • Surgeons
  • Coordinators
  • Transportation networks
  • Clinical teams

Every unnecessary delay creates risk.

Every communication breakdown matters.

Every missing piece of information matters.

Now ask yourself:

How different is that from medical billing?


Why This Matters to Every Physician Owner

Most physicians think their biggest financial problem is reimbursement.

I would argue it is something else.

Revenue friction.

The claim denial isn't the problem.

The denial is the symptom.

The missing documentation is the symptom.

The coding error is the symptom.

The appeal is the symptom.

The delayed payment is the symptom.

The real disease exists upstream.

And healthcare keeps treating symptoms instead of causes.


A Hot Take About Medical Billing

Medical billing is not a billing problem.

It's a data quality problem.

Read that again.

Most healthcare organizations spend enormous energy optimizing what happens after patient care.

Very few optimize what happens before the claim is created.

That is backwards.

Imagine a cardiologist treating heart failure by focusing only on swelling while ignoring the failing heart.

That would be absurd.

Yet healthcare organizations routinely do the operational equivalent.

They invest heavily in:

  • Collections
  • Appeals
  • Denial management
  • Recovery services

Instead of fixing the upstream documentation and workflow failures generating those problems.


The Most Expensive Word in Healthcare

The most expensive word in healthcare isn't "cancer."

It isn't "malpractice."

It isn't even "denial."

The most expensive word is:

Rework.

Rework means:

  • Entering information twice
  • Correcting coding errors
  • Chasing authorizations
  • Appealing denials
  • Hunting for documentation
  • Fixing preventable mistakes

Healthcare doesn't measure rework well.

If it did, many organizations would discover that their largest hidden expense isn't labor.

It's inefficiency.


What Most Healthcare Leaders Miss

Dáithí's story became international news because people saw a child.

Not a process.

Not a system.

Not a policy.

A child.

That's important.

Because healthcare leaders often fall in love with systems and forget that patients experience stories.

Patients never say:

"My healthcare journey suffered due to fragmented operational architecture."

They say:

"I waited."

"I was confused."

"I couldn't get an answer."

"I didn't know what was happening."

Every operational failure eventually becomes a human experience.


Three Experts. Three Lessons.

Dr. Atul Gawande

Dr. Gawande's work repeatedly demonstrates a simple truth:

Complex systems fail because of small failures.

Not large ones.

Checklist failures.

Communication failures.

Process failures.

Tiny breakdowns compound.

Lesson

Small friction creates massive consequences.


Dr. Eric Topol

Topol has spent years discussing healthcare technology's promise.

Yet his underlying message remains remarkably consistent:

Technology should serve clinicians.

Not burden them.

Lesson

The best technology is often invisible.

If users constantly notice the technology, it may already be failing.


Dr. Robert Wachter

One of healthcare's leading digital transformation thinkers.

His work highlights a reality many organizations learn too late.

Implementation matters more than innovation.

Lesson

Bad workflows digitized remain bad workflows.


A Statistic Every Physician Should Remember

Studies suggest physicians may spend nearly two hours on administrative work for every hour spent with patients.

Think about how extraordinary that is.

Imagine telling a surgeon:

For every hour you operate, you must spend two additional hours explaining why you operated.

No other profession would tolerate that ratio.

Healthcare normalized it.


The Healthcare Industry's Favorite Addiction

Complexity.

Healthcare has become addicted to complexity.

More forms.

More clicks.

More approvals.

More vendors.

More software.

More intermediaries.

More dashboards.

More meetings.

More bureaucracy.

And then we wonder why physicians burn out.

Complexity is often mistaken for sophistication.

It isn't.

Many times it is simply inefficiency wearing a suit.


The Organ Donation Lesson Nobody Is Talking About

Most coverage focuses on the successful transplant.

That's understandable.

But the deeper lesson may be elsewhere.

Dáithí's family didn't merely wait.

They organized.

Advocated.

Educated.

Mobilized.

Changed public awareness.

Influenced policy.

One family generated more public engagement than many healthcare campaigns.

Why?

Because stories move people.

Data informs.

Stories transform.


The Billion-Dollar Mistake

Healthcare organizations spend billions optimizing downstream processes.

The greatest opportunity often sits upstream.

At the moment information enters the system.

Because every downstream workflow depends on upstream accuracy.

Bad data creates:

  • Bad claims
  • Bad decisions
  • Bad reporting
  • Bad forecasting
  • Bad patient experiences

The quality of healthcare operations ultimately depends on the quality of healthcare information.


What This Means for Physician-Owned Practices

If you're running a clinic today, ask yourself:

Where is friction hiding?

Not where is revenue leaking.

Where is friction hiding?

Those are often the same answer.

Look for:

  • Repeated tasks
  • Repeated errors
  • Repeated denials
  • Repeated phone calls
  • Repeated corrections

Patterns reveal friction.

Friction reveals opportunity.


The Future of Healthcare Will Reward Simplicity

Everyone predicts AI will transform healthcare.

I agree.

But not for the reason most people think.

The winners won't be the organizations with the most AI.

The winners will be the organizations with the cleanest data and simplest workflows.

AI amplifies systems.

Good systems get better.

Broken systems get amplified.


Final Thoughts: The Story Behind the Story

A child waited eight years for a heart.

That is the headline.

But the deeper story is about what happens when healthcare friction is removed.

A donor family says yes.

A clinical team coordinates care.

A community supports a cause.

A system works.

A life changes.

Healthcare leaders should pay attention.

Because every organization has its own version of friction.

Every clinic.

Every hospital.

Every payer.

Every health technology company.

The question isn't whether friction exists.

The question is whether you're willing to see it.

And in healthcare, what we fail to see often becomes what patients are forced to feel.


Frequently Asked Questions

What is the biggest cause of claim denials?

Common causes include documentation gaps, coding inaccuracies, authorization issues, and eligibility errors.

How can small clinics improve revenue cycle performance?

Start by measuring denial rates, standardizing documentation, and identifying workflow bottlenecks.

Can AI completely eliminate claim denials?

No. AI can help reduce administrative burden, but underlying documentation and data quality remain critical.

Why do physicians experience revenue leakage?

Revenue leakage often occurs through missed charges, documentation issues, coding errors, and inefficient workflows.

What should clinic owners measure first?

Denial rate, clean claim rate, days in A/R, and net collection rate.


About the Author

Dr. Daniel Cham is a physician and medical consultant with expertise in healthcare technology, medical practice management, operational efficiency, and medical billing. His work focuses on translating complex healthcare challenges into practical strategies that help physicians, clinic owners, and healthcare organizations improve performance while maintaining focus on patient care.

Connect with Dr. Cham on LinkedIn to learn more.


Important Note

This article is intended for educational and informational purposes only. It provides a general discussion of healthcare operations, revenue cycle management, and industry trends. It should not be interpreted as legal, medical, financial, or regulatory advice. Readers should seek guidance from qualified professionals regarding their specific circumstances.


What if claim denials aren't a billing problem at all?

What if they're evidence of a deeper data quality problem hiding inside healthcare operations?

I'm curious:

Where is the biggest source of friction in your organization today?

Share your perspective below.


Continue the Discussion

Healthcare advances when clinicians, operators, innovators, and patients share what works.

Explore practical insights, operational strategies, and real-world perspectives that help improve healthcare delivery, strengthen practice performance, and support meaningful innovation.

Knowledge creates momentum. Learning creates change. Progress starts with the next insight.

PS: A complimentary resource is available in the Featured section of my LinkedIn profile. No signup required.

Get Involved

What is the biggest source of operational friction in your practice today?

Share your experience in the comments.

If this perspective resonates, consider ♻️ reposting to help other physicians and clinic owners rethink how billing and operational workflows impact patient care.


References

  1. Dáithí Mac Gabhann receives long-awaited heart transplant after years of advocacy and waiting for a donor heart.
    https://www.thesun.ie/health/17331920/familys-joy-boy-rare-condition-heart-transplant/
  2. American Medical Association resources on physician administrative burden and practice sustainability.
    https://www.ama-assn.org
  3. Medical Group Management Association resources on revenue cycle performance and physician practice operations.
    https://www.mgma.com

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A Child Waited 8 Years for a Heart. Most Clinics Wait 60 Days to Get Paid. Both Reveal the Same Healthcare Problem.

  "One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring fo...