Healthcare loves metrics. Wait times. RVUs. Patient volumes.
For Erica Taylor, MD, MBA, an orthopedic hand and upper extremity surgeon at Durham, N.C.-based Duke Health and vice president of health equity for Duke Health Integrated Practice, those numbers are not the problem.
The problem is what happens when organizations mistake them for success.
Over the course of a career that has taken her from practicing hand surgeon to chief of orthopedics to one of Duke Health’s senior leaders, Dr. Taylor has learned that one of healthcare’s greatest challenges is deciding which data matters enough to measure.
“The definition of quality can change depending on what room you’re in,” Dr. Taylor told Becker’s.
As chief of orthopedics at Duke Raleigh (N.C.) Hospital, she learned quickly that surgeons, administrators, patients and executives often evaluate success through different lenses. The lesson fundamentally changed her approach to leadership.
“I needed to learn about relationships. I needed to learn about consensus building. I needed to learn that it was not an us-versus-them mentality,” she said. “We were truly stronger and better together.”
That realization led her deeper into health equity work — not because she left quality improvement behind, but because she came to see them as inseparable.
“If you have any investment in workflows, quality or access to care, you are doing health equity work,” she said. The statement reflects a broader belief that runs through much of her thinking: Healthcare organizations often focus on what is easiest to count rather than what matters most.
When access isn’t really access
Few words appear more frequently in healthcare strategy meetings than access. Health systems report appointment availability. Boards review wait times. Executives monitor new-patient lead times. Orthopedic practices celebrate shorter scheduling delays.
The assumption is shorter waits mean better access, though Dr. Taylor said that definition is incomplete. “We trip over ourselves when we treat access like a front-door metric,” she said.
A patient may get an appointment quickly and still face barriers to care. They may struggle to afford treatment or arrange transportation. They may live in a community without access to rehabilitation services. They may undergo successful surgery and still fail to recover because the resources needed afterward are unavailable.
As a hand surgeon, she sees that reality regularly.
“I am very clear that occupational hand therapy is almost as important as what I do in the operating room,” she said.
A technically perfect operation means little if a patient cannot access the therapy necessary to regain function. That is why Dr. Taylor frequently points to a framework known as the “five A’s of access”: accessibility, affordability, availability and acceptability among them, as a reminder that healthcare access extends beyond scheduling.
“The question isn’t whether patients get in,” she said. “The question is whether they get well.”
When productivity isn’t really value
Dr. Taylor sees a similar problem inside physician organizations. Healthcare systems frequently evaluate physicians through productivity: RVUs. Procedure volumes. Revenue generation.
The numbers matter. They are also incomplete.
“We tend to think about physicians as revenue generators,” she said.
If she were advising a hospital CEO preparing an orthopedic program for the next decade, her first recommendation would be simple: Understand the value of every surgeon beyond their productivity report.
Some physicians mentor younger colleagues. Some strengthen referral relationships. Some build trust within communities. Some shape organizational culture. Some elevate the reputation of an entire health system.
Those contributions rarely appear on a dashboard, yet they can determine whether programs thrive.
“If you took time to understand the value they bring and invested in developing that value, it would be amazing how much more retention you would find,” Dr. Taylor said.
The observation arrives at a time when physician turnover remains one of healthcare’s most expensive challenges.
“You might say you can hire another hand surgeon,” she said. “But I don’t know that you would find another one who does all the things.”
In an industry increasingly focused on recruitment, Dr. Taylor believes organizations may be overlooking a simpler strategy: Understanding what they already have.
When equity isn’t really representation
Dr. Taylor believes healthcare has made a similar mistake in conversations about equity. Too often, she said, organizations reduce the discussion to representation alone. The issue is much broader. At its core, health equity is about helping every patient achieve the highest possible level of health.
“If you’re invested in workflows, quality or access to care, you’re doing health equity work,” she said. Many clinicians already participate in that work without calling it equity. Every effort designed to improve outcomes remove barriers and make healthcare easier to navigate falls under equity.
All of it contributes to the same objective; the challenge is helping organizations recognize that connection. Quality and equity are often the same priority viewed from different angles.
“The ones who know their communities, understand their patient characteristics and work alongside partners from different backgrounds tend to have this gift of seeing people for who they are and meeting them where they are,” Dr. Taylor said.
Importantly, she argues that trust works both ways. “The best physician leaders understand it’s not only up to the patient to trust us,” she said. “It’s up to us to be trustworthy.”
A technology assumption leaders keep getting wrong
If there is a second recommendation she would give healthcare executives, it is to stop making assumptions about technology adoption. Many organizations continue to view digital transformation through a generational lens: Older patients are assumed to resist technology, while younger patients are assumed to prefer entirely digital experiences.
Dr. Taylor believes both assumptions are flawed, adding that technology should be viewed as an experience issue.
The real question is not whether a patient is willing to use technology. The question is whether technology solves a meaningful problem. Healthcare leaders who understand the specific frustrations and barriers facing their communities will be more successful than those who rely on broad demographic assumptions.
“Let’s not bet that AI is going to solve everyone’s problem,” she said.
When data becomes a barrier
Perhaps Dr. Taylor’s strongest criticism is reserved for data.”We have gatekept data,” she said. The irony is difficult to ignore.
Physicians are increasingly expected to improve outcomes, reduce variation and deliver value. Yet the data — and healthcare organizations collect enormous amounts of it — that could help them answer important questions often remains buried behind requests, approvals and reporting structures. By the time answers arrive, the opportunity to act may already be gone.
Dr. Taylor envisions something different: a healthcare environment where a surgeon can ask questions about their patients and receive an answer in real time. The goal is not simply transparency. It is ownership.
“We would have a lot less resistance to administration,” she said. “We would be more collaborative because everyone would have a chance to have buy-in.”
For leaders preparing for the future, she sees data democratization as one of healthcare’s most overlooked opportunities.
A different definition of success
Another theme that has followed Dr. Taylor throughout her leadership journey is competition.
Hospitals compete. Physicians compete. Health systems compete. She believes there is another model: Collaboration.
“There’s more that we have in common than what separates us,” she said.
The statement sounds simple. In practice, it challenges some of healthcare’s most deeply embedded habits. Because many of the industry’s biggest challenges do not stem from a lack of talent, technology or effort; they stem from a failure to align around the right goals.
The organizations that lead the next decade of healthcare may not be the ones with the fastest appointment availability, the largest physician groups or the most impressive dashboards.
They may be the ones that learn to measure success differently. Because though getting patients through the front door is important, helping them get well is what matters. And understanding the difference may become one of healthcare’s most important competitive advantages.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
