It is what it is until it isn't
"It is what it is." When I heard "Johnny Football" use this quote in one of his all-too-frequent press interviews I was compelled to write about what is becoming a fairly ubiquitous quote in the world of healthcare (and apparently the world of sports).
I first heard, “it is what it is” from a tough-as-nails corporate nurse in a meeting held some 13 years ago. The discussion was blunt. The reality was that we did not have a lot of room to negotiate the terms of whatever bitter pill we, the front line soldiers in the nursing facility, were being forced to swallow.
But in my mind this overused phrase has come to represent the acceptance of the current reality that is not subject or amenable to change.
So often in healthcare we are faced with regulatory/reimbursement/operational realities that are thrust upon us from the highest reaches of our world. Operational realities become facts on the ground in the battle zone, where we conduct our daily task of delivering healthcare against insurmountable odds.
At a very intuitive level I understand this catch phrase's popularity. However, I wonder if it can move us as healthcare practitioners from critically thinking/questioning subject matter experts to automatons accepting blindly the dictums and dictates emanating from all corners of our world.
This thought occurred to me as I was attempting as a private citizen to generate some interest in trying to halt a program impacting poor older adults. As part of my one man “campaign” I had a conversation with a political action committee. With little time left before this farce of a process became le fait accompli, I was struck that these people had not considered a legal approach to thwarting this governmental overreach. In point of fact they seemed to be solely concentrating on reacting to this change.
As I reflected over the many years of non-stop change we all have experienced, I concluded that healthcare practitioners have become very adept at reacting to change. This has become a survival mechanism of sorts and is almost automatic – too automatic possibly.
A second conversation that I had with a consumer advocate on this subject was rather short and abrupt. This person told me that they were not interested in the global fairness or unfairness of this particular scheme. After some very curt words from this individual I was cut off with the phrase, “it is what it is”.
In 2015, I would wish for everyone in the healthcare field to listen carefully for the rejoinder, “it is what it is.” Upon hearing these five words we all should engage our critical thinking skills and pledge to go to the source of the problem or regulation to ask if there is something hidden that should make us question the very premise and context of what is being foisted upon us.
When we hear those words, we should definitely also dig a little deeper below the obvious. Healthcare practitioners have an ultimate responsibility to those that are served and simply uttering, “it is what it is” in no way cancels our responsibility
Kevin R. McMahon is the Coordinator for Summa Institute for Senior Health.