Business guru Peter Drucker famously wrote, “If you want something new, you have to stop doing something old.” American medicine often responds to modern challenges by adding more people, more processes and more layers onto outdated systems. Last month’s survey asked a different question: Which legacy practices are most overdue for replacement? Here are the results:

My thoughts: The survey results point to a clear conclusion. Patients (and their families) aren’t frustrated by the clinical care they receive. They’re irked by the system surrounding it. That’s why administrative complexity, insurance interference and difficulty accessing care dominate the list. Of course, these challenges affect both patients and clinicians, even if the survey does not distinguish between the two groups.

At the root of these frustrations is cost. As doctors and hospitals charge more, insurers respond by restricting access through prior authorization and other financial controls. In turn, clinicians look for ways to maximize reimbursement. The result is a system in conflict rather than alignment.

That’s why the preferred replacement models are so telling and assuring. Readers are not asking for more layers or tighter controls. They are gravitating toward Generative AI to help control chronic disease more effectively, reducing life-threatening and expensive complications including heart attacks, strokes and kidney failure). Combined with home-based monitoring and virtual care, these tools could improve outcomes while reducing the need for costly interventions. It’s an outcome that would benefit patients, clinicians and insurers simultaneously.

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