A transplant survivor’s journey reveals why the future of medicine is not just better technology. It is rebuilding healthcare around human connection, physician time, and smarter systems.
“The secret of the care of the patient is in caring for
the patient.” — Dr. Francis Peabody, Harvard Medical School
Healthcare’s Greatest Innovation Problem May Not Be
Technology. It May Be That We Forgot the Human Being Inside the System.
At eight months old, Hannah Fleming was not thinking about
becoming a nurse.
She was fighting to survive.
Diagnosed with biliary atresia, a rare condition that
affects the bile ducts and can lead to liver failure, Hannah’s future depended
on something no algorithm could create.
A human decision.
A donor family’s generosity.
A medical team’s expertise.
A community’s support.
She received a liver transplant.
The operation saved her life.
But the real story began decades later.
Hannah did not simply become a transplant survivor.
She became the person standing beside other transplant
patients when they were afraid.
She became the nurse who could look at a frightened family
and say:
“I understand.”
Not because she studied the patient experience.
Because she lived it.
The Healthcare System Often Measures What Is Easy to
Count — But Misses What Matters Most
Modern medicine is extraordinary.
We can:
- Replace
failing organs
- Sequence
genomes
- Detect
disease earlier
- Develop
targeted therapies
- Perform
procedures once considered impossible
Yet healthcare continues to struggle with something much
more basic:
Making people feel cared for while navigating the system.
We measure:
- Length
of stay
- Readmission
rates
- Productivity
- Revenue
- Claims
processed
But how do we measure:
- A
caregiver’s fear while waiting for a transplant?
- A
physician’s exhaustion after spending hours on paperwork?
- A
patient’s frustration trying to navigate insurance?
- A
nurse’s emotional burden carrying other people’s suffering?
Healthcare has become incredibly advanced.
But advancement without connection creates a dangerous
imbalance.
The Contrarian Healthcare Question
The healthcare industry asks:
“How do we make medicine more efficient?”
Perhaps we should ask a different question:
“Efficient for whom?”
A system can become more efficient on paper while becoming
more exhausting for the people inside it.
A hospital can process more patients.
A clinic can submit more claims.
A company can automate more workflows.
But if physicians have less time with patients and patients
feel less understood, have we truly improved healthcare?
Efficiency should not mean removing humanity.
It should mean protecting it.
The Patient Experience Is One of Healthcare’s Most
Valuable Data Sources — And We Rarely Capture It
Healthcare has invested heavily in data.
We collect:
- Lab
results
- Imaging
studies
- Genetic
information
- Claims
data
- Prescription
history
- Clinical
documentation
But we often overlook one of the most important datasets:
The lived experience of the patient.
Patients understand things healthcare systems cannot always
see.
They know:
- Where
confusion happens
- Where
trust breaks down
- Which
moments create anxiety
- Which
interactions create confidence
Hannah Fleming’s story represents a powerful idea:
A patient is not just the recipient of healthcare.
A patient can become one of healthcare’s greatest teachers.
The Same Human Problem Exists Behind Every Physician’s
Exam Room
The irony of modern medicine is this:
Physicians are trained to solve complex human problems.
But many are trapped inside systems creating unnecessary
complexity.
A physician can diagnose rare diseases.
Manage chronic conditions.
Perform life-changing procedures.
Yet after clinic hours, many are forced to battle:
- Insurance
rules
- Documentation
requirements
- Claim
denials
- Prior
authorization delays
- Revenue
cycle confusion
The physician who spends years mastering medicine may spend
evenings learning the language of reimbursement.
This is not a physician problem.
This is a system design problem.
The Hidden Crisis in Independent Medicine
Small and medium-sized physician practices are facing a
quiet crisis.
Not because doctors cannot provide excellent care.
They can.
Not because patients do not value independent practices.
They do.
The challenge is operational survival.
Many clinics are squeezed between:
Rising Costs
Staff salaries.
Technology expenses.
Administrative overhead.
Increasing Complexity
More payer requirements.
More documentation expectations.
More compliance obligations.
Limited Resources
Small practices do not have the infrastructure of large
health systems.
The result?
Physicians spend less time doing the work they trained for.
And more time managing the machinery around healthcare.
Healthcare Has a Revenue Problem — But the Root Cause Is
Not What Most People Think
The common explanation:
“Medical billing is complicated.”
True.
But incomplete.
The deeper problem:
Healthcare billing is often a data quality problem
disguised as a billing problem.
A denied claim is rarely born at the billing desk.
The problem often begins earlier:
A missing detail.
An incomplete workflow.
A documentation gap.
A disconnected system.
By the time a claim is denied, the healthcare system is
already reacting too late.
We keep trying to fix the final step.
The real opportunity is improving the first step.
The Future of Healthcare Is Moving Upstream
The healthcare industry has spent decades building solutions
downstream.
After something goes wrong:
- After
the denial
- After
the error
- After
the delay
- After
the administrative burden appears
But the next generation of healthcare innovation will move
upstream.
Instead of asking:
“How do we fix more denied claims?”
We should ask:
“Why did the claim become vulnerable in the first place?”
Instead of asking:
“How do we make physicians work faster?”
We should ask:
“How do we remove unnecessary work entirely?”
Why I Built OnnX: A Physician’s View of Healthcare
Complexity
After years practicing medicine and studying healthcare
operations, I noticed a pattern.
Healthcare does not suffer from a shortage of intelligence.
It suffers from disconnected systems.
The people closest to patients often understand the problems
best.
But they are rarely the ones designing the workflows.
This creates a gap between:
Clinical reality.
Operational reality.
Technology reality.
OnnX was built around closing that gap.
The mission is not to create another complicated healthcare
tool.
The mission is to simplify medical billing operations for
small and medium-sized physician clinics by improving the connection between
clinical information, workflow, and reimbursement.
The goal:
Less administrative friction.
More physician time.
Better practice sustainability.
Because every hour returned to a physician is an hour that
can be spent caring for patients.
The Biggest Healthcare Innovation May Be Giving Doctors
Their Time Back
Healthcare leaders often ask:
“What technology will transform medicine?”
My answer:
The most meaningful technology may be the one that restores
what healthcare has slowly lost.
Time.
Time to listen.
Time to explain.
Time to think.
Time to care.
Because the most advanced healthcare system in the world
still depends on one simple interaction:
One human being helping another human being.
The Lesson From a Transplant Nurse’s Journey
Hannah Fleming’s story is not only about transplantation.
It is about transformation.
A patient became a caregiver.
A survivor became a healer.
A difficult experience became a source of empathy.
Healthcare should create more moments like this.
Not just healthier patients.
But empowered people who carry healing forward.
The Healthcare Industry Has Spent Billions Fixing
Symptoms. We Need to Start Fixing Causes.
Healthcare has no shortage of solutions.
There are:
- Electronic
health records
- Practice
management systems
- Revenue
cycle vendors
- Coding
platforms
- Analytics
dashboards
- Automation
tools
- Artificial
intelligence platforms
Yet many physicians still say the same thing:
“I spend too much time fighting the system.”
That should force healthcare leaders to ask an uncomfortable
question:
If we have invested so much in healthcare technology, why
does healthcare still feel so difficult for the people delivering it?
The answer may be uncomfortable.
Because the problem is not simply that healthcare lacks
technology.
The problem is that healthcare has accumulated layers of
technology on top of fragmented workflows.
We have digitized complexity.
But we have not always redesigned the process itself.
Healthcare Does Not Have a Billing Problem. It Has an
Information Architecture Problem.
This is one of the biggest misconceptions in healthcare
operations.
People often think:
“Medical billing is a finance problem.”
But billing is actually the final stage of a much larger
information journey.
A patient enters the system.
A clinician evaluates the patient.
Documentation is created.
A diagnosis is recorded.
A procedure is performed.
A claim is generated.
A payer evaluates the information.
Payment follows.
Every step depends on the quality of the information before
it.
A billing team cannot repair incomplete clinical
information.
A coder cannot create documentation that does not exist.
A technology platform cannot magically fix a broken
workflow.
The root issue is upstream.
Healthcare revenue is created at the moment information
is captured.
The Downstream Healthcare Trap
Most healthcare organizations operate reactively.
Something breaks.
Then someone fixes it.
A claim is denied.
The billing department investigates.
A physician note is incomplete.
Staff sends reminders.
A payer rejects information.
The team appeals.
This creates a cycle:
Problem → Reaction → Correction → Delay → Frustration
The healthcare industry has become very good at recovery.
But recovery is expensive.
The better question is:
Why are we designing systems that depend on recovery in
the first place?
The Upstream Healthcare Model
A better approach begins earlier.
Before the claim exists.
Before the denial happens.
Before revenue is lost.
The upstream model focuses on:
1. Better Information Capture
The quality of healthcare data determines the quality of
healthcare outcomes.
Clinicians need workflows that make accurate documentation
easier.
Not harder.
2. Better Clinical-Operational Alignment
Healthcare often separates:
Clinical teams.
Administrative teams.
Financial teams.
But patients experience one healthcare journey.
The system should reflect that.
3. Better Visibility
Many practice owners know revenue is declining.
But they do not always know why.
The future clinic needs operational intelligence:
- Where
are claims failing?
- What
patterns create delays?
- Which
workflows need improvement?
Three Healthcare Experts on the Future of Medicine
Expert Perspective #1: Dr. Atul Gawande — Complexity Is a
System Problem
Surgeon, writer, and healthcare researcher Dr. Atul
Gawande has spent years studying why highly trained professionals still
struggle inside complex systems.
His work highlights an important idea:
Expertise alone cannot overcome poorly designed systems.
A physician may know exactly what should happen medically.
But if the surrounding process creates friction, the entire
system suffers.
Healthcare leadership lesson:
Do not ask:
“How do we make people work harder?”
Ask:
“How do we design work better?”
Expert Perspective #2: Dr. Eric Topol — Technology Should
Give Humans More Time
Cardiologist and digital medicine expert Dr. Eric Topol
has emphasized that technology should enhance healthcare professionals rather
than replace them.
The goal of artificial intelligence should not be:
More automation.
More screens.
More digital tasks.
The goal should be:
More human connection.
Healthcare innovation lesson:
The best technology creates more time for conversations that
matter.
Expert Perspective #3: Dr. Donald Berwick — Healthcare
Must Return to Its Purpose
Healthcare quality leader Dr. Donald Berwick has
consistently advocated for patient-centered care and improving the healthcare
experience.
His message challenges organizations to remember:
Healthcare is not simply a transaction.
It is a relationship.
Healthcare leadership lesson:
Operational improvement should support compassion, not
compete with it.
The Numbers Behind the Problem: Why Administrative Burden
Matters
Physician Burnout Is an Operational Issue
Physician burnout is often described as a personal wellness
challenge.
But the causes are frequently structural.
Major contributors include:
- Administrative
burden
- Excessive
documentation
- Loss
of autonomy
- Reduced
patient interaction time
- Workflow
inefficiency
When physicians spend more time managing systems than caring
for patients, healthcare loses something valuable.
Revenue Cycle Complexity Has Real Consequences
Independent practices operate under increasing pressure.
Common challenges include:
- Claim
denials
- Delayed
reimbursement
- Staffing
shortages
- Increasing
overhead
- Complex
payer requirements
For a large health system, inefficiency may become a budget
problem.
For a small physician practice, inefficiency can threaten
survival.
Why Independent Clinics Are Especially Vulnerable
Small and medium-sized clinics are often the backbone of
community healthcare.
They provide:
- Local
access
- Long-term
patient relationships
- Personalized
care
- Specialty
services
But they often lack:
- Large
administrative departments
- Dedicated
technology teams
- Extensive
financial resources
This creates an imbalance:
The physicians closest to patients often have the fewest
resources to solve operational problems.
Recent Healthcare Trend: The Growing Demand for
Sustainable Physician Practices
Healthcare conversations increasingly focus on
sustainability.
The industry is recognizing that improving healthcare
requires more than improving hospitals.
It requires supporting the physicians delivering care every
day.
The future discussion is shifting from:
“How do we make doctors more productive?”
to:
“How do we create systems where doctors can practice
medicine sustainably?”
The Biggest Mistake Healthcare Technology Companies Make
Many healthcare startups fail because they begin with the
wrong question.
They ask:
“What technology can we build?”
Instead of:
“What healthcare problem deserves to disappear?”
Technology is not the innovation.
Problem-solving is the innovation.
Practical Framework: How Physician Owners Can Reduce
Administrative Friction
Step 1: Perform a Workflow Reality Check
Do not start with software.
Start with observation.
Ask:
Where does time disappear?
Where do mistakes repeat?
Where do employees become frustrated?
Step 2: Identify Revenue Leakage Points
Review:
Documentation
Are clinical notes supporting services provided?
Coding
Are coding decisions consistent?
Claims
What are the most common denial reasons?
Follow-up
How long does reimbursement take?
Step 3: Create a Monthly Practice Intelligence Review
Every clinic should understand:
- Top
denial causes
- Days
in accounts receivable
- Collection
trends
- Administrative
workload
- Patient
access issues
Data should create decisions.
Not just reports.
Step 4: Choose Technology Based on Outcomes
Before buying technology, ask:
Does this:
- Save
physician time?
- Reduce
staff burden?
- Improve
visibility?
- Improve
patient experience?
- Reduce
unnecessary complexity?
If the answer is unclear, the technology may not solve the
real problem.
Legal Considerations in Healthcare Automation
Healthcare innovation must operate within important
boundaries.
Organizations must consider:
HIPAA and Data Security
Protected health information requires appropriate
safeguards.
Documentation Integrity
Automation should support accurate records.
It should never encourage unsupported documentation or
inappropriate billing.
Human Accountability
Healthcare decisions require responsible oversight.
Technology can assist.
Professionals remain accountable.
Ethical Considerations: The Question Healthcare Leaders
Must Ask
Not every improvement is a true improvement.
A healthcare innovation should be evaluated by more than
financial performance.
Ask:
Does this improve patient trust?
Does this reduce clinician burden?
Does this improve access?
Does this protect dignity?
The purpose of healthcare is not efficiency alone.
The purpose is better human outcomes.
The Future of Healthcare Operations
The next generation of healthcare will likely be defined by
three shifts:
1. From Reactive to Predictive
Healthcare will increasingly identify problems before they
occur.
2. From Fragmented to Connected
Clinical, operational, and financial information will need
to work together.
3. From Technology-Centered to Human-Centered
The winners in healthcare innovation will not simply build
powerful tools.
They will build tools people trust.
The Question Healthcare Leaders Should Be Asking
Not:
“What can AI do?”
But:
“What unnecessary burden can we remove so humans can do
what they do best?”
Because the future of healthcare is not about replacing
humanity.
It is about protecting it.
The Future of Medicine Will Not Be Built by Technology
Alone
The story of Hannah Fleming began with a transplant.
But it was never really about the transplant.
It was about what happened afterward.
A child who received care became a caregiver.
A patient who needed hope became someone who gave hope.
A healthcare experience became a healthcare mission.
This is the future lesson for healthcare leaders:
The greatest healthcare systems will not simply create
healthier patients. They will create empowered people who continue improving
healthcare.
The next era of medicine will require more than clinical
breakthroughs.
It will require better systems.
Systems that respect:
- Patients
- Physicians
- Nurses
- Care
teams
- Independent
practices
- Communities
Because healthcare is ultimately a human relationship
supported by technology.
Not a technology system occasionally visited by humans.
Frequently Asked Questions
FAQ 1: Why should physicians care about medical billing
and revenue cycle management?
Because financial health and patient care are connected.
A financially unstable practice eventually affects:
- Staffing
decisions
- Patient
access
- Technology
investment
- Physician
sustainability
Revenue cycle management is not simply an accounting
function.
It is part of healthcare delivery infrastructure.
A physician practice cannot provide excellent care if the
operational foundation is collapsing underneath it.
FAQ 2: Is the healthcare system too complicated to fix?
No.
But the industry must stop confusing complexity with
quality.
A complicated system is not necessarily a sophisticated
system.
The best systems often feel simple to the people using them.
Patients do not want complicated healthcare.
Physicians do not want complicated healthcare.
Healthcare leaders should not accept complexity as
inevitable.
FAQ 3: Will AI eliminate jobs in medical billing?
The more likely future is transformation, not elimination.
AI can help with:
- Pattern
recognition
- Workflow
automation
- Data
analysis
- Administrative
support
But healthcare still requires:
- Human
judgment
- Compliance
awareness
- Relationship
management
- Decision-making
The question is not:
“Will AI replace humans?”
The better question:
“Which tasks should humans never have had to do manually
in the first place?”
FAQ 4: What should physician owners do before investing
in new technology?
Start with the problem.
Do not begin with:
“We need AI.”
Begin with:
“What problem consumes the most time, money, or
frustration?”
A practical approach:
Step 1
Identify the workflow problem.
Step 2
Measure the impact.
Step 3
Redesign the process.
Step 4
Use technology to support the improved workflow.
Technology should be the accelerator.
Not the starting point.
FAQ 5: How can independent clinics compete with large
healthcare systems?
Independent practices have something large organizations
often struggle to replicate:
Relationships.
Community trust.
Physician accessibility.
Personalized care.
The opportunity is not becoming a smaller hospital.
The opportunity is becoming a smarter, more human-centered
practice.
Myth Busters: Challenging Healthcare Assumptions
Myth: “Healthcare Has a Technology Problem”
Reality:
Healthcare has an alignment problem.
We have technology.
We have data.
We have talented professionals.
The challenge is connecting these pieces effectively.
Myth: “More Documentation Means Better Healthcare”
Reality:
Documentation should support care.
It should not overwhelm care.
The goal is not more documentation.
The goal is meaningful documentation.
Myth: “Physician Burnout Is Just a Wellness Issue”
Reality:
Burnout is often a system design issue.
Telling physicians to simply “practice self-care” ignores
many structural problems:
- Administrative
overload
- Inefficient
workflows
- Reduced
autonomy
- Excessive
bureaucracy
Healthcare organizations must redesign environments, not
only offer wellness programs.
Myth: “Revenue Optimization Means Putting Money Before
Patients”
Reality:
A sustainable practice supports better patient care.
Financial stability allows clinics to:
- Maintain
staff
- Invest
in technology
- Expand
services
- Improve
access
The goal is not choosing between business and medicine.
The goal is making them support each other.
The Physician Owner’s Practical Checklist
1. Audit Your Administrative Burden
Ask:
- What
tasks consume physician time?
- What
tasks frustrate staff?
- What
processes require repeated correction?
2. Understand Your Revenue Cycle
Know:
- Your
denial rate
- Your
collection rate
- Your
accounts receivable trends
- Your
most common billing issues
You cannot improve what you cannot see.
3. Listen to Frontline Staff
The people performing the work every day often understand
the problems best.
Ask:
“What process would you eliminate if you could?”
The answer may surprise you.
4. Protect the Physician-Patient Relationship
Every operational decision should eventually connect back to
one question:
Does this help physicians spend more meaningful time with
patients?
Three Questions Every Healthcare Founder Should Answer
Question 1: Are You Solving a Real Pain or a Market
Trend?
Healthcare does not need another impressive demonstration.
It needs solutions that remove daily frustration.
Question 2: Are You Designing for Healthcare Reality?
Healthcare is not like other industries.
Trust matters.
Safety matters.
Workflow matters.
Adoption matters.
Question 3: Are You Building Technology Around People?
The best healthcare companies understand:
Technology serves healthcare.
Healthcare does not serve technology.
Final Thought: Healthcare’s Future Depends on Those
Willing to Question the System
Every major healthcare improvement started with someone
asking:
“Why do we do it this way?”
Progress requires curiosity.
Progress requires courage.
Progress requires people willing to redesign what everyone
else has accepted.
Join the Conversation
I would like to hear from physicians, clinic owners, nurses,
and healthcare leaders:
What is one healthcare workflow problem that you believe
should no longer exist?
Share your perspective in the comments.
Your experience may help another healthcare professional
facing the same challenge.
Take Action
If this article resonates:
- Add
your voice to the conversation.
- Share
what is working in your practice.
- Challenge
outdated healthcare assumptions.
- Help
other physicians rethink how healthcare operations can improve.
Consider reposting this article so more clinicians and
healthcare leaders can participate in the discussion.
Healthcare improves when the people closest to the problem
become part of the solution.
Further Reading
1. American Medical Association — Physician Burnout and
Practice Sustainability
The AMA provides research and resources focused on physician
well-being, administrative burden, and improving healthcare practice
environments.
American Medical Association Physician Health Resources
2. Centers for Medicare & Medicaid Services —
Healthcare Quality and Value-Based Care
CMS provides information regarding healthcare quality
improvement, reimbursement models, and healthcare transformation.
Centers for Medicare & Medicaid Services
3. National Institutes of Health — Organ Transplantation
Research
NIH provides educational resources and research regarding
transplantation, patient outcomes, and medical innovation.
About the Author
Dr. Daniel Cham is a physician, medical consultant, and
healthcare entrepreneur focused on the intersection of medicine, healthcare
operations, technology, and medical billing innovation.
As founder of OnnX, an AI-powered medical billing
SaaS platform designed for small and medium-sized physician practices, Dr. Cham
focuses on reducing administrative friction and helping clinicians spend more
time on what matters most: patient care.
His work explores practical strategies for improving
healthcare delivery, strengthening independent practices, and building
technology that supports — rather than replaces — human connection.
Connect with Dr. Cham on LinkedIn to
learn more.
Disclaimer / Note
This article is provided for educational and
informational purposes only.
It is intended to share perspectives on healthcare
operations, technology, and practice management. It does not constitute medical
advice, legal advice, compliance guidance, or financial advice.
Healthcare professionals should consult appropriate
qualified experts when making decisions specific to their practice,
organization, or patients.
Continue the Conversation
Healthcare transformation happens when ideas move beyond
discussion and become action.
Explore practical strategies, healthcare insights, and
behind-the-scenes perspectives focused on improving medicine, operations, and
innovation.
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If This Perspective Resonates
Consider reposting this article to help physicians, clinic
owners, and healthcare innovators rethink how administrative systems affect the
future of medicine.
Your voice can help shape the next generation of healthcare.
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