Rise up: Fellow clinicians: We can’t wait for permission

We’re tired. I know. The cognitive load of modern practice is immense—the endless documentation, the referral chasing, the systems that seem designed to slow us down rather than help us care for patients. Most days it feels like the system is working against us.But here’s what I’ve learned after three and a half decades in medicine: waiting for someone else to fix this isn’t working. If we want healthcare to change, we have to lead that change ourselves.Show up where decisions are madePolicy is being written right now—in ministry offices, in health authority boardrooms, in standards committees. These decisions shape our daily practice for years to come. And too often, they’re made without meaningful clinician input.We can’t complain about policies we didn’t help shape. Find a committee. Join a working group. Respond to consultations. Yes, it’s time you don’t have. But the alternative—having decisions made for us by people who’ve never seen a patient—is worse.You don’t need to be the loudest voice in the room. Sometimes the most effective leadership happens quietly, under the radar. But you do need to be in the room.Adopt what works – nowWe resisted AI scribes for too long. We were peppered with concerns about accuracy, privacy, workflow disruption. All legitimate. But for me, when I finally tried one, the impact was immediate: I stopped looking at my computer. I looked at my patients. The quality of my encounters transformed.The evidence on many practice—changing tools is already clear. We don’t need another study. We need adoption. If something demonstrably improves care or reduces burden, try it. Be an early adopter, not a late skeptic. Our colleagues watch what we do—when respected clinicians embrace innovation, others follow.Yes, new tools require learning. Yes, there are adjustment periods. But the cost of not changing—continued burnout, continued inefficiency, continued frustration— is higher. And once you are familiar with the first tool of automation, move onto the others. There is much that we can do in day-to-day care that no longer needs to be manual or done by us.Speak honestly about what’s brokenClinicians have credibility that others in the healthcare system don’t. When we speak, people listen—patients, media, policymakers. We need to use that voice.Tell the truth about what’s happening in your practice. Share stories—with appropriate privacy, of course—about system failures affecting patient care. When you see something that works, celebrate it publicly. When you see something broken, name it clearly. This takes courage. And time. But the stories we tell matter. They empower us.We’re trained to detect problems and diagnose them accurately. Apply that skill to the system itself. Be specific. Be constructive. But don’t stay silent.Mentor the next generation differentlyI used to watch residents spend entire patient encounters staring at screens, typing furiously, glancing up occasionally. They were learning that this was normal—that being a doctor meant being a transcriptionist.We can teach differently. Show learners what patient-centred care looks like when technology supports rather than dominates the encounter. Demonstrate that the computer can be turned off. Or even better, that it can be shared with the patient. Model the curiosity and presence that drew us to medicine in the first place when it comes to digital and innovation.The habits we instil in training persist for careers. Let’s make sure we’re teaching the right ones.Lead without waiting for permissionLeadership in healthcare transformation doesn’t require a title. It requires showing up, speaking up, and anteing up—doing the work even when it’s hard.Start in your own practice. Optimize your own workflow. Share what you learn with colleagues. Push back on tools and processes that don’t serve patients. Advocate for better. Form coalitions. Build networks. This is how we effect change.We became physicians to help people. The system makes that harder than it should be. But we are not powerless. We have expertise, credibility, and collective influence.It’s time to use it.Dr. Darren Larsen is a health-tech consultant with more than three decades of experience in the medical and health information technology fields. This item originally appeared on his website.

Rise up: Fellow clinicians: We can’t wait for permission

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