August 5, 2026 Salus Health Care Forum

Mark

Recently, there was a 75th anniversary of the family practice program, which had been actually a general practice program prior to family practice being recognized as a specialty.

And I was able to meet up with some people that I hadn’t seen since 1983, and a whole slew of residents. And many of them came up to me. And I’ve been out of active practice for some time now, but I had such gratitude. I didn’t know how much I had impacted other people’s lives. And they came up to me. It was very touching. And I realized how much I missed that. It’s been inculcated in me to be of service. And so, I do meals on wheels, but in terms of direct patient contact, I really haven’t had that for a while. And the other thing that I thought about was forgiveness. A lot of people that I stepped on along the way. I was righteous or less than forgiving. So, I was thinking of that as well.

Howard

From my perspective, I appreciate the opportunity to reflect on my purpose. And I think it’s been consistent for a long time. Hopefully, it matures a bit over the years, but it’s really been to identify those big pieces of policy that guide our healthcare system and approach them by changing them for more productive and more appropriate ways, big ways and little ways, and build coalitions of people through dialogue or through writings to support those changes. So, early in my career as the victim of policy, I recognized that it’s not much fun being the victim of policy and that by design, our system does allow us to have a voice. By design, it’s carried out exactly in the way it was designed, but given enough voice, enough clarity that we can change policies. And I’ve been doing that bits and pieces for decades. And sadly, I don’t think the system is a lot better, but bits and pieces of it are.

Jeremy

Well, you also have to say it could be a lot worse. Sometimes we have to remind ourselves of that. I find that helpful as I go through the day of realizing, well, how bad would it be if we hadn’t done anything? It could be pretty awful.

Howard

I think we generally recognize or thoughtful people recognize is there are some really good and relatively straightforward ways to create a better healthcare delivery system. Certainly, other countries have done that. And I think with goodwill and fortune, we could do that here.

Bill B

I want to pick up what Howard was saying. There’s the work of Martin Seligman about helplessness. I was thinking about Seligman, Howard, when you were talking about a victim policy. This is such a powerful statement. There needs to be a whole book titled Victim of Policy. I was thinking, Jeremy, when you talk about self-regulation, preceding that is the sense of hopefulness. You assume that you have the capacity to be something other than a victim. So, Howard, you made the transition from being a victim of policy. You said: wait a minute. Victim of policy means an external locus of control. There’s a lot of research about locus of control and depression. But Howard, there’s that transition that you made that I think all of us have had. This is the foolishness of saying we could do something. And this group, Howard, is made up of a bunch of fools. Solus is an appeal for health. And probably in many ways, it’s a foolish appeal. No one is there to answer this appeal. However, this appeal is accompanied by our exploration regarding how do we find hopefulness. Seligman’s learned optimism is an important part of what engages our Salus conversation. This learned optimism is especially important as we look forward to next year after the elections. And we ask; “what the hell are we’re going to do now?” Are we going to have some opportunities for reform or a new democracy, as some people are calling it. I think we require some learned optimism, which is very hard right now, given what’s happened in the world.