The Double Bind of Increasing Clinic Efficiency: A New Model Offers Opportunities to Build Resilience of Systems and Individuals

Case study submitted as part of Lancet Commission call for case studies.

Team members / location: Laura L. Bellaire, USA

Issue: Healthcare delivery generates significant waste and emissions. Current valuation models focus on cost and compensation, driving patient and clinician behavior. To inspire sustainable changes, we need to rethink these models, considering planetary health. Intervention: Causal loop diagrams (CLD) serve as a powerful tool for modeling complex relationships in the economic and sustainability sectors. They offer an alternative to linear growth-focused models and instead highlight stakeholder inter-relatedness and opportunities for iterative adaptation.

Outcomes:

• Clinical
  Utilizing an alternative model to assess clinic throughput, one can place value on current system shortcomings. The number of patients seen by a physician each day must be weighed against the benefits of decreased wait times, increased time spent on patient education, and improved physician-patient connection and engagement.
• Environmental
  The proposed model aims to build health system resilience. It also provides an alternative to production-focused metrics that are known to generate excessive waste and emissions.
• Social 
  This model introduces how clinicians can lead in rethinking outdated systems, impacting resources, patient outcomes, innovation, and education. It also helps address clinician burnout and improve patient and caregiver literacy and empowerment.
• Financial
  The proposed model encourages exploring alternative healthcare compensation structures. It offers a framework for assessing clinic throughput with a focus on resilience, rather than volume, without prescribing a specific transformation path.
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Key learning point: CLD mapping offers an opportunity to consider the intangible impacts of current clinical practices on clinicians and patients.