What a Labrador at a Bronx children's hospital can teach physicians, clinic owners, and healthcare innovators about patient experience, administrative waste, and the contrarian idea that healthcare's next breakthrough may come from preventing work, not automating more of it.
“First, experience – and patient experience in particular
– is not a survey or score. Rather, it is something a patient, family members
or care partners live through.”
That is Jason
A. Wolf, president and CEO of The Beryl Institute, in Healthcare IT
News on October 19, 2026. His point is simple: healthcare is not just what
organizations measure. It is what people actually experience.
And sometimes, that experience is shaped by a four-legged
healthcare worker who has never attended medical school, never opened an
electronic health record, and probably has no opinion about artificial
intelligence.
Her name is Polly.
A Dog Named Polly, a Child With Cancer, and an
Uncomfortable Healthcare Question
At Children's Hospital at Montefiore Einstein in the Bronx,
New York, a four-year-old Labrador named Polly helps bring comfort to
hospitalized children.
According to a New York Post report published October
19, 2026, Polly visited an eight-year-old cancer patient who was experiencing
tremors after doctors removed the child's breathing tube and reduced sedative
medications.
Polly works with Katy Dessick, a certified child life
specialist. Dessick reportedly observed that the child's tremors became less
frequent when Polly was present.
It is an affecting story, but accuracy matters. This
observation does not establish that Polly caused the change in tremors, and it
does not mean a facility dog can replace medical treatment. It reminds us that
the experience of being ill includes more than clinical procedures.
The report also describes Dr. Adit L. Tal, a
pediatric hematologist-oncologist at Children's Hospital at Montefiore
Einstein, discussing the role facility dogs can play in helping young patients
feel more comfortable.
Another Labrador, Lev, age seven, visits children at
Maimonides Medical Center in Brooklyn, New York. His handler is identified in
the report by the first name Gabriel.
These are different people doing different jobs in different
hospitals. Yet their stories point toward an important principle: the human
experience of healthcare deserves attention alongside clinical treatment.
Now, let's move from a children's hospital to a small
independent medical practice.
A patient arrives for an appointment. The clinician is
ready. The patient is ready.
Then someone discovers the referral is missing.
The authorization status is unclear. The insurance
information in one system does not match the information in another. A document
that should have been available yesterday now requires three phone calls, two
portal logins, and a heroic amount of patience.
Suddenly, the appointment has a supporting cast of
administrative problems.
Healthcare has become remarkably good at turning one missing
piece of information into a multi-department investigation.
What if the real innovation is not getting better at
fixing these problems, but preventing more of them from happening in the first
place?
That is the question I believe physicians, clinic owners,
and healthcare technology founders should be asking.
My Contrarian Take: Healthcare Does Not Need Another Tool
for Every Problem
I am a physician-entrepreneur and founder of OnnX, an
AI-powered medical billing software initiative focused on small and
medium-sized medical practices.
My perspective is increasingly shaped by one distinction:
Automating work is not the same as eliminating the need
for that work.
Suppose a claim is rejected because required information is
missing.
One solution is to identify the problem, locate the
information, correct the claim, resubmit it, and monitor the outcome.
That may be necessary. But it is not the end of the
investigation.
Why was the information missing? Was it never collected? Was
it entered inconsistently? Did a handoff fail? Was the requirement
misunderstood? Did the information exist but remain inaccessible to the person
who needed it?
If the same cause produces the same correction week after
week, making the correction faster may improve productivity without solving the
underlying problem.
It is a bit like buying a faster mop while ignoring the
leaking pipe.
The mop may be excellent. The floor may look better. The
water bill remains a mystery.
Healthcare should absolutely improve necessary work. It
should also challenge unnecessary work.
Not every denial is preventable. Not every administrative
step is waste. Documentation, authorization, compliance, and appropriate review
can be essential to safe and accountable care.
The opportunity is to distinguish necessary complexity from
preventable rework.
The goal should not be to automate every problem. It
should be to make fewer preventable problems occur.
The Administrative Burden Is Not Just an Annoyance
For independent physicians, administrative complexity is a
business problem, a workforce problem, and sometimes an obstacle to timely
care.
The American Medical Association's 2025 prior authorization
survey, reported in May 2026, surveyed 1,000 practicing physicians. The
findings are sobering:
- 95%
said prior authorization delays access to necessary care.
- 79%
reported that patients abandon treatment because of authorization
challenges.
- 26%
said prior authorization had contributed to a serious adverse event
involving a patient in their care.
- Physicians
reported completing an average of 40 prior authorizations per week.
- Prior
authorization consumed an average of 13 hours of physician and staff
time each week.
- 94%
said prior authorization contributes to physician burnout.
- 88%
reported that prior authorization increases overall healthcare
utilization.
These are physicians' reported experiences, not proof that
every practice faces the same circumstances or that one software product can
resolve them. But the findings make one thing difficult to ignore:
administrative processes can consume resources that healthcare teams need
elsewhere.
Imagine reclaiming even a portion of the time spent chasing
information, checking status, and repeating work. What would a practice do with
those hours?
More patient communication? Better follow-up? Less overtime?
More time for complex cases?
Those are worthwhile questions. But the answers should be
measured, not assumed.
Three Perspectives on the Human Side of Healthcare
1. Jason A. Wolf: Patient Experience Is What People Live
Through
In his October 19, 2026, Healthcare IT News
interview, Jason A. Wolf argued that patient experience extends beyond surveys
and scores. It includes the experiences of patients, families, care partners,
and the workforce.
The implication for clinic owners is that patient experience
cannot be delegated entirely to a satisfaction survey.
A patient who repeatedly supplies the same information,
waits for an unresolved referral, or receives confusing instructions is
experiencing the system, too.
So is the staff member who spends half the morning tracking
down a document that should already be available.
The practical question is not simply, “How satisfied are our
patients?”
It is also, “Where does our process create avoidable
friction, and what are we doing about it?”
2. Katy Dessick: Pay Attention to the Person, Not Just
the Task
Katy Dessick's work with Polly offers a reminder that care
happens in the context of human emotion and vulnerability.
A child facing cancer is not simply a diagnosis, a treatment
plan, or a series of clinical measurements. The child's experience matters.
Likewise, an administrative problem is not merely a line
item in a work queue. It may affect a patient's next appointment, a staff
member's workload, or a clinician's ability to complete a task efficiently.
The lesson is not that every practice needs a therapy dog.
It is that healthcare teams should understand the people affected by the
processes they design.
3. Researchers: Good Ideas Still Need Evidence
A randomized clinical trial published in JAMA Network
Open in March 2025 examined therapy dogs added to standard child-life
support in a pediatric emergency department.
The study included 80 children. At 45 minutes, the group
that received therapy-dog support experienced a greater reduction in reported
anxiety than the comparison group. At 120 minutes, the difference in
child-reported anxiety was not statistically significant.
The study supports a measured conclusion: therapy dogs may
help reduce anxiety in this setting, but the results should not be exaggerated
beyond the evidence.
Healthcare technology deserves the same standard.
A compelling demonstration is not proof of sustained
operational improvement. A promising AI feature is not proof of lower costs. A
faster workflow is not automatically a better outcome.
Measure the result. Check the limitations. Keep what
works. Change what does not.
These individuals and researchers are included for their
relevant perspectives; their inclusion does not imply endorsement of OnnX.
OnnX: Move Intelligence Upstream
OnnX is being developed around an idea: many administrative
problems should be addressed before they create downstream work.
Medical billing does not begin when a claim is submitted.
The eventual claim depends on information gathered, documented, checked, and
transferred throughout the patient's journey.
A problem that starts upstream can become a correction
downstream.
For example, consider a service that requires prior
authorization. A practice may need to identify the requirement, collect
supporting information, submit the request, track its status, verify the
response, and ensure the result is available to the people who need it.
An upstream approach would focus on making those steps
visible and reliable before the service or claim reaches a point where missing
information causes avoidable disruption.
That means distinguishing a request that has been submitted
from an authorization that has actually been approved. It means flagging gaps
without inventing answers. It means routing unresolved issues to an accountable
person.
The same principle may apply to referral status, insurance
eligibility, documentation completeness, coding checks, and claim preparation.
The OnnX design philosophy follows six steps:
Capture → Structure → Preserve → Propagate → Act → Learn
- Capture
relevant information at the appropriate point.
- Structure
it so it can be interpreted consistently.
- Preserve
context rather than losing it between systems.
- Propagate
it to authorized people and workflows that need it.
- Act
through appropriate, clearly assigned next steps.
- Learn
from outcomes and recurring failures.
The ambition is not to replace every system or automate
every decision. It is to explore how upstream intelligence can help practices
identify information gaps earlier and reduce avoidable administrative work.
This is a product direction under evaluation, not a claim
that every capability is already available or that specific savings have been
demonstrated.
A responsible healthcare founder should be able to
distinguish a vision from a validated result.
Seven Steps Clinic Owners Can Take Now
You do not need a large AI budget to begin improving a
process. Start with a problem that is specific, recurring, and measurable.
Step 1: Identify the recurring headache.
Ask staff which administrative issue interrupts their work
most often. Look for missing referrals, unclear authorization status,
inconsistent insurance details, repeated documentation requests, or preventable
claim corrections.
Step 2: Map what really happens.
Document the actual workflow, including handoffs, systems,
exceptions, and follow-up. The official process may have three steps. The
staff's spreadsheet, phone calls, and workarounds may reveal ten.
Step 3: Establish a baseline.
Count how often the problem occurs, how long it takes to
resolve, and what consequences follow. Record staff time and relevant
operational outcomes where practical.
Step 4: Investigate the root cause.
Ask why the problem happened, not just who fixed it. Was
information never collected? Was ownership unclear? Did a transfer fail? Was a
requirement misunderstood?
Step 5: Standardize the process.
Define what information is needed, where it belongs, who
verifies it, and how completion is confirmed. Do not remove safeguards or
clinically important exceptions merely to make the workflow look simpler.
Step 6: Pilot a narrow improvement.
Try a structured checklist, clearer ownership, a validated
integration, or a carefully scoped automation. Involve the staff who will use
it. Keep human review for consequential decisions.
Step 7: Compare results and adjust.
Did the problem happen less often? Did resolution time fall?
Did the change create new errors? Did staff find the process easier to use?
If the evidence is weak, do not declare victory because the
software has a nice interface.
Six Ways Automation Can Make Things Worse
1. Automating a broken process. A faster bad process
is still a bad process.
2. Adding alerts without responsibility. If nobody
owns the next action, another notification is just digital confetti.
3. Trusting AI output without verification. AI can
miss context, misinterpret data, or produce plausible but incorrect answers.
4. Measuring activity instead of results. The number
of tasks automated tells you little about whether the practice improved.
5. Ignoring staff feedback. A tool that looks
efficient to management may create extra work for the people using it.
6. Promising savings before measuring them. Claims
about reduced denials, recovered revenue, or time saved should be supported by
appropriate evidence.
The underlying principle is simple: buy technology to
solve a defined problem, not to prove that your organization is keeping up with
technology.
Five Myths Worth Challenging
Myth 1: Every denial can be prevented.
Reality: Some denials arise from correctable administrative
problems; others involve coverage, clinical documentation, medical necessity,
contractual terms, or payer decisions. Diagnose the cause first.
Myth 2: More automation always means lower costs.
Reality: Automation can introduce implementation, oversight,
exception handling, and correction costs. Measure the net result.
Myth 3: Billing is only the billing department's
responsibility.
Reality: Billing outcomes can depend on information
collected during scheduling, registration, clinical documentation, referral
management, and authorization.
Myth 4: AI can replace professional judgment.
Reality: AI may assist with information retrieval,
prioritization, and consistency checks. It does not eliminate accountability
for clinical decisions, coding, or appropriate oversight.
Myth 5: Patient experience and operational efficiency are
separate goals.
Reality: Clearer information and fewer avoidable handoffs
may support both, but the benefits should be tested rather than presumed.
Legal and Ethical Guardrails
Healthcare automation must respect applicable privacy,
security, billing, coding, and contractual requirements.
Before using a new tool, practices should evaluate access to
protected health information, vendor responsibilities, security controls,
applicable business associate agreements, auditability, and procedures for
handling errors or incidents.
An automated system must not invent clinical documentation,
misrepresent authorization status, or submit unsupported claims. AI-generated
content should be reviewed at a level appropriate to its intended use and
potential consequences.
Ethical implementation also requires attention to fairness,
transparency, privacy, and accountability. A tool that saves time but
introduces hidden errors is not a success.
Consult qualified compliance, legal, coding, and security
professionals where appropriate. This article is educational, not legal or
billing advice.
Seven Measures That Matter More Than a Flashy Dashboard
Start small. Choose a handful of measures that reflect the
problem you are trying to solve:
- Rework
frequency: How often does the same issue recur?
- Resolution
time: How long does it take to close the loop?
- First-pass
claim acceptance: What share of claims are accepted without initial
rejection or correction, using a consistent definition?
- Denial
rate by cause: Which causes are within the practice's control?
- Days
in accounts receivable: How long does it take to collect outstanding
balances?
- Administrative
time: How much staff time goes toward repetitive work?
- Patient
impact: Are avoidable delays, repeated requests, or communication
failures decreasing?
Interpret changes carefully. Payer mix, claim volume,
staffing, and policy changes can affect results. A pilot should be evaluated
against a credible baseline, not a convenient story.
What the Future of Healthcare Should Look Like
Healthcare will never be free of complexity. Patients have
different needs. Clinical judgment remains essential. Payer requirements and
exceptional circumstances will continue to exist.
But complexity is not a reason to accept every source of
rework as inevitable.
The next generation of useful healthcare systems may not be
defined by how many tasks they automate. It may be defined by how well they
preserve information, identify gaps, coordinate handoffs, and support the right
action at the right time.
For physicians, that means demanding evidence from vendors.
For clinic owners, it means understanding the problem before
buying a solution.
For founders, it means building around real operational
needs rather than adding AI because AI is fashionable.
For patients, the hoped-for result is straightforward: less
avoidable confusion, fewer preventable delays, and more attention from the
people caring for them.
And that brings us back to Polly.
A facility dog cannot repair a broken data handoff. An AI
platform cannot replace human compassion. A billing system cannot solve every
problem in healthcare.
But each has a role when it serves the people who depend on
the system.
Polly's story reminds us to look beyond the procedure and
see the person. The administrative burden reminds us to look beyond the
rejected claim and investigate the process that produced it.
Perhaps healthcare's next breakthrough is not doing
everything faster. Perhaps it is needing to fix fewer things in the first
place.
Your Turn: What Work Should Never Have Existed?
If you own or operate a medical practice, consider this
question:
What is one recurring administrative task in your
practice that should be prevented rather than automated?
Share your experience in the comments. Your answer may help
another practice recognize a problem it has accepted as normal.
If this perspective resonates with you, repost the article
to start a conversation among physicians, clinic owners, medical billers, and
healthcare innovators.
I am exploring these questions through OnnX and welcome
thoughtful perspectives from people doing the work every day.
PS: Visit the Featured section of my LinkedIn profile
for a free resource. No signup is required.
References and Further Reading
1. Patient experience and leadership
Jason A. Wolf, president and CEO of The Beryl Institute,
discusses why patient experience should be part of organizational culture and
strategy, not merely a score.
Healthcare
IT News, October 19, 2026: Patient experience is not a score – it's a
leadership strategy
2. The administrative burden of prior authorization
The American Medical Association's 2025 physician survey,
reported in May 2026, describes physicians' experiences with delays, workload,
and prior authorization reform.
3. Research on therapy dogs and pediatric anxiety
A randomized clinical trial evaluated therapy dogs alongside
standard child-life support in a pediatric emergency department.
Kelker
et al., JAMA Network
Open, March 3, 2025: Therapy Dogs for Anxiety in Children
in the Emergency Department
4. The original human-interest story
The report describing Polly, Katy Dessick, the child, and
facility dogs working at New York hospitals.
New
York Post: How dogs at NYC hospitals are helping sick kids heal
About the Author
Dr. Daniel Cham is a physician, medical consultant,
and entrepreneur working at the intersection of healthcare technology, practice
management, and medical billing. He is the founder of OnnX, an initiative
exploring how upstream intelligence may help independent medical practices
identify and reduce preventable administrative work.
His focus is on translating healthcare's operational
challenges into practical questions, evidence-informed improvements, and better
experiences for physicians, staff, and patients.
Connect on LinkedIn.
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Disclaimer: This article is for general educational and
informational purposes only. It is not medical, legal, billing, coding,
compliance, or financial advice. Requirements and circumstances vary. Consult
qualified professionals for advice on specific situations.
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