The founders of the Johns Hopkins School of Medicine could have chosen to limit their plans to simply graduating outstanding physicians. But their vision was much grander. They had the health of the entire society, for generations to come. They set out to transform the existing system. And they played a huge role in doing just that.

Brigham Young University could do the same.

BYU recently announced plans for a new medical school. Medical graduates from Provo will excel, save lives and ease suffering, I’m sure. But when they enter the real world of medicine, they will encounter an incredibly flawed system and quickly become part of that system. I am an emergency physician and assistant and experience the frustrations every day.

Readers are probably already aware of the many challenges and shortcomings of our health care system: misaligned financial incentives that lead to widespread bankruptcy; high levels of burnout among medical service providers; on levels of mental health challenges; maternal mortality rates that are unacceptably high, especially among black women; metabolic diseases such as diabetes; and fragmented and wasteful care, to name a few.

Don’t get me wrong. The nurses, administrators, fellow doctors and many others I work with in the healthcare field are some of the brightest, most caring and hardworking people I know. And I’m very proud of the care we provide. But we inherited a system that makes no sense on so many levels.

In 1893, when the first medical students enrolled at Johns Hopkins in Baltimore there was already a vision in place for the first hospital and medical school in the country, even in the world. They took steps that were, at the time, revolutionary and risky. They embraced the scientific method. They admitted women – though only after Mary Elizabeth Garrett put this provision on her donation to the school. They raised the admissions requirements. They are committed (as mandated by benefactor Johns Hopkins) to providing care to all, regardless of skin color or ability to pay. They linked the medical school with the hospital and research institutes.

The model that solidified at Johns Hopkins spread to other schools over the years. As medical graduates from this new era of medical schools established practices in communities across the country, they created hospitals and worked alongside nurses. The healthcare system we are familiar with today has solidified.

But not all developments were positive. The ideal of health care for all has not been realized, and women, people of color, and the poor have too often been left behind. Science has not always defeated authority. Our national health policies over the decades have been fraught with unintended negative consequences. We, as a society, have overemphasized episodic treatments, not health. Today our system feels hopelessly stuck.

For me, it’s energizing to remember that change was also very difficult for Johns Hopkins’ founders. They transformed the system. Why can’t we? What steps could the planners of the new BYU medical school take to catalyze the transformation of global health systems? I suggest the following:

1. Develop and widely disseminate a bold and clear vision. I suggest “We aim to catalyze a new paradigm for our healthcare system based on health and wellness for all at the lowest cost to the system.”

2. Create an institute at BYU for health systems transformation. Given that less than 20% of our health is due to healthcare, the institute would cross disciplines and departments.

3. Ground the institute in complex, adaptive social systems theory and methods. After all, our healthcare system is more like an ecosystem than a machine. The diverse people and organizations that influence health continually adapt over time, with tension between a shared vision of health for society and more limited short-term goals.

4. Require all BYU medical school enrollees as pre-med students in health systems transformation and all other health professionals (nursing, public health, etc.) to be minors. While there are advantages to a diversity of majors (after all, I majored in philosophy), the need to transform our healthcare system is great and outweighs any disadvantages.

5. Lead the world in competency-based licensing and certification of healthcare professionals. For example, allow a registered nurse with extensive experience and excellence in a particular medical specialty the opportunity to become a board-certified physician in that specialty in much less than the current seven to 11 years.

The founders of Johns Hopkins made history and improved the health of millions because they dreamed big and relentlessly insisted that bold vision—not the status quo or inherited conventions—determine the details of their journey. I hope BYU does the same.

Chad Swanson, DO, is a full-time emergency physician in Orem, Utah, and has no role in BYU medical school planning. He is a graduate of both BYU (BA in Philosophy) and Johns Hopkins (MPH) and has published academic papers in scientific journals including Lancet on health systems transformation. He currently posts daily YouTube videos about transformational changes and is writing a non-fiction book about a visionary black physician in Raleigh in the 1890s named Lawson Scruggs. Recently gave a TEDx talk about the life of Dr. Scruggsand implications for today.

Salt Lake Tribune is committed to creating a space where Utahns can share ideas, perspectives and solutions that move our state forward. We rely on your understanding to do this. Learn how to share your opinion Hereand email us at [email protected].