2016 was a big year in healthcare. MACRA was finalized, the Zika virus became a worsening threat and many topics were fiercely debated: the fate of the ACA, insurance mega-mergers and rising drug prices to name a few. Straight from the mouths of healthcare executives, physicians, nurses, politicians, journalists, academic thought leaders and others on the frontlines, the following 50 quotes relate to some of the year's biggest news, most pressing clinical discoveries and industry trends. A few fall into the category of timeless advice or insight, nonetheless spoken in 2016.
Here they are, listed in alphabetical order by source.
1. "Current and former employees from at least 10 UHS hospitals in nine states said they were under pressure to fill beds by almost any method — which sometimes meant exaggerating people's symptoms or twisting their words to make them seem suicidal — and to hold them until their insurance payments ran out," wrote Rosalind Adams, investigative reporter for BuzzFeed News.Buzzfeed published her nearly 9,000-word article "Intake" in December, which detailed Ms. Adams' yearlong news investigation of admission practices at Universal Health Services psychiatric hospitals.
2. "As the [premium] rates rise, the healthier people pull out because the out-of-pocket costs aren't worth it," Aetna CEO Mark Bertolini said in October at Bloomberg's The Year Ahead Summit in New York, suggesting America's young and healthy are likely to forego buying ACA health plans as they weigh rising premiums against other lifestyle expenses. "Young people can do the math. Gas for the car, beer for Fridays and Saturdays, health insurance."
3. "If you don't think healthcare is about power, you haven't been paying attention," Former CMS Administrator Don Berwick, MD, now president emeritus and senior fellow at the Institute for Healthcare Improvement, said during his keynote address at the IHI National Forum in December.
4. "It's not negligence," Bibiana Bielekova, MD,an internationally renowned neuro-immunologist at the National Institutes of Health, told The Washington Post about why she was twice passed up as a tenure candidate. "Women are considered second-rate citizens. They are fully aware that this is happening, the leadership. It's happening with their blessing."
5. "Bring your whole self to work; not only your knowledge and expertise, but also your values. Stay true to who you are and have the courage of your convictions. If you do, you will become an authentic and courageous leader — something intensely needed at this time in healthcare. And you will have the power to change your workplace and the community around you," Mary Brainerd, president and CEO of Bloomington, Minn.-based HealthPartners, told Becker's Hospital Review when asked to offer words of advice to recent graduates pursuing careers in healthcare.
6. "Looking back, I wish we had better anticipated the magnitude and acceleration of the rising financial issues for a growing minority of patients who may have ended up paying the [list price] or more," Mylan CEO Heather Bresch said before the U.S. House of Representatives Committee on Oversight and Government Reform in September. "We never intended this." Ms. Bresch was defending Mylan's price hike for the EpiPen.
7. "We almost finished each other's sentences," Humana CEO Bruce Broussard said of his first encounter with Aetna CEO Mark Bertolini, while on the witness stand in December during the antitrust trial regarding a merger of the two companies.
8. "While the game encourages positive activities such as walking and family togetherness, hospitals are not the place to search for fictional characters," the California Hospital Association said in a statement advising hospitals to ban the popular smartphone game "Pokemon Go" from their campuses due to safety issues.
9. "The situation is bad and getting worse," Margaret Chan, MD, director-general of World Health Organization, told delegates at the U.N. General Assembly in September of the growing crisis of drug resistance. "Last month, an increase in the number of drug-resistant pathogens forced WHO to revise its treatment guidelines for chlamydia, syphilis and gonorrhea. On current trends, a common disease like gonorrhea may become untreatable, and doctors facing patients will have to say, 'I'm sorry, there's nothing I can do for you.'"
10. "We have to continue to keep those people covered otherwise the promise for hospitals of more patients, even though we are being paid less, is going to cause more and more hospitals to have major economic problems. We need to continue to cover those individuals, the question is how we do it, and we do it most efficiently," Cleveland Clinic CEO Toby Cosgrove, MD,told Fox Business Network in late November.
11. "I'm sure many of my fellow young, corporate America working women of color can all understand my frustration when I say I'm sick of being disrespected," Tamika Cross, MD, a resident at University of Texas Health Science Center in Houston, wrote in an October Facebook post after crew members on a Delta Airlines flight allegedly resisted her help during a medical emergency because they did not believe she was a physician. Her post went viral and spurred a social media campaign called #WhatADoctorLooksLike that challenges stereotypes in medicine.
12. "We are inundated with a plethora of micro-regulations, and that, I think, just makes the business much more complicated than it needs to be. It consumes excess resources and doesn't do enough to improve outcomes for patients. This is not to suggest that I'm against compliance, but the constant development of dozens of regulations on an ongoing basis makes the machinery of progress move much more slowly than it could," Northwell Health CEO Michael Dowling told Becker’s Hospital Review in March.
13. "I think we would prefer the snakes stay out of the hospital," Marce Edwards, spokesperson for Tacoma (Wash.) General Hospital, told The News Tribune in May. A patient's pet python was missing for roughly a month and emerged from the hospital's ceiling ventilation April 30.
14. "I would say if I have one driving force, it is to keep commitments to our customers. When I have corporate philosophy class with all the new folks who come into Epic, we go over the philosophies behind Epic. That is the central message: To keep commitments to customers," Epic CEO Judy Faulkner told Becker's Hospital Review in March.
15. "I'm the sixth CEO at Geisinger. The first five were surgeons. When the psychiatrist shows up and says, 'Give people money back,' I think they want to call the executive search firm and say, 'What happened?'" David Feinberg, MD, president and CEO of Danville, Pa.-based Geisinger Health System said about the health system's ProvenCare program, in which patients can request and receive refunds for less than satisfactory hospital experiences. In its first year, Geisinger officials expected to refund more than $500,000 to patients.
16. "It basically shows us that the end of the road isn't very far away for antibiotics — that we may be in a situation where we have patients in our intensive care units, or patients getting urinary tract infections for which we do not have antibiotics," CDC Director Tom Frieden, MD,told The Washington Post in May after a strain of E. coli resistant to last-resort antibiotics was discovered in the U.S.
17. "Everyone's talking about it, no one really knows how to do it — everyone thinks everyone else is doing it, so we all say we're doing it," said Deb Gage, president and CEO of Medecision, likening population health to teenage sex during a panel at the Becker's Hospital Review 5th Annual CEO + CFO Roundtable in November.
18. "Even more than what you think, how you think matters," Atul Gawande, MD, wrotefor The New Yorker in June. His essay about scientific thinking was delivered as a commencement speech at California Institute of Technology in Pasadena. "The stakes for understanding this could not be higher than they are today, because we are not just battling for what it means to be scientists. We are battling for what it means to be citizens."
19. "I had to pay $39.35 to hold my baby after he was born," Ryan Grassley posted on Reddit with a photo of an itemized hospital bill depicting a $39.35 charge for "skin to skin after C-sec." The post attracted more than 12,000 comments along with national media attention. Mr. Grassley later disclosed the hospital was Utah Valley Hospital in Provo, and he said he and his wife were more amused than outraged by the charge.
20. "When I was a young nurse in the operating room I experienced [bullying] myself, and I did have times when I felt very disrespected, both from my colleagues as well as other people on the team," Linda Groah, MSN, RN, executive director and CEO of AORNsaid in a livestream Facebook interview hosted by the Association of periOperative Registered Nurses. "I must admit there were times where I wasn't sure nursing was really the profession for me because it just took me so far back to think that we could treat each other this way."
21. "The 962 pages of MACRA are so overwhelmingly complex, that no mere human will be able to understand them. … As a practicing clinician for 30 years, I can honestly say that it's time to leave the profession if we stay on the current trajectory," John Halamka, MD, CIO of Beth Israel Deaconess Medical Center in Boston, wrote in a post on his blog.
22. "Our mouths were ajar, and we couldn't believe that in 2016 now, in the middle of the Great Lakes, we couldn't guarantee a population access to good drinking water," Mona Hanna-Attisha, MD, the pediatrician who exposed the Flint water crisis, told CNN about her reaction to her own data that showed the percentage of children in Flint with lead poisoning had doubled after the city changed the source of its water supply.
23. "Last year, Elizabeth Holmes topped the Forbes list of America's Richest Self-Made Women with a net worth of $4.5 billion," Forbes reporter Matthew Herper wrote about Theranos' CEO in June. "Today, Forbes is lowering our estimate of her net worth to nothing." Forbes made the change in light of negative news, investigations and lawsuits the company faced since an October 2015 Wall Street Journal article exposed its practices. Forbes also lowered its estimate of Theranos' net worth from $9 billion to $800 million.
24."There was ample evidence that male and female physicians practice medicine differently," said Ashish Jha, MD, professor of health policy and director of the Harvard Global Health Institute. "Our findings suggest that those differences matter and are important to patient health. We need to understand why female physicians have lower mortality so that all patients can have the best possible outcomes, irrespective of the gender of their physician." Dr. Jha was a senior author of a landmark 2016 study published in JAMA Internal Medicine that examined how differences in the way male and female physicians practice affect clinical outcomes. In the study, better patient outcomes were linked to care from female physicians.
25. "The U.S. government and private sector spend a lot of money on heart disease research and prevention. They also spend a lot of money on cancer research and prevention. It is time for the country to invest in medical quality and safety proportional to the mortality burden it bears," Martin A. Makary, MD, professor of surgery and health policy and management at Baltimore-based Johns Hopkins University, wrote in a letter to Thomas Frieden, MD, director of the CDC. Dr. Makary wrote the letter with three medical students after The BMJ published his study, which found the true third leading cause of the death in the U.S. is medical errors.
26. "It's great you want a seat at the table, but you have to have table manners," Lt. Gen. Mark Hertling (Ret.) told Becker's Hospital Review about physicians who want their voices to be heard by hospital leadership.
27. "We've got this appetite now because [Republicans] haven't had power to do everything exactly the way we want it done. I believe the Republican Party has a very impressive and historic opportunity to put in place a governing structure that will last for a very long time if they have the discipline not to overreach," Mike Leavitt, former governor of Utah, former secretary of HHS and founder and chairman of Leavitt Partners, said on a radio show, "Conversations on Health Care."
28. "As this takedown should make clear, healthcare fraud is not an abstract violation or benign offense. It is a serious crime. The wrongdoers that we pursue in these operations seek to use public funds for private enrichment," said Loretta Lynch, 83rd Attorney General of the U.S., according to NBC News. "They target real people — many of them in need of significant medical care. They promise effective cures and therapies, but they provide none. Above all, they abuse basic bonds of trust — between doctor and patient; between pharmacist and doctor; between taxpayer and government — and pervert them to their own ends." Ms. Lynch oversaw the largest Medicare fraud takedown in U.S. history in 2016.
29. "The days to an appointment is really not what we should be measuring," VA Secretary Bob McDonald said during a May 23 breakfast with reporters hosted by the Christian Science Monitor in Washington. "What we should be measuring is the veteran's satisfaction. What really counts is how does the veteran feel about [his or her] encounter with the VA. When you go to Disney, do they measure the number of hours you wait in line?" Sec. McDonald later apologized for the comment.
30. "I'm very proud to be the first female president and it does send a message to other women aspiring to leadership roles," Redonda Miller, MD,said of her appointment as the first female president of Baltimore-based Johns Hopkins Hospital, according to The Baltimore Sun. "I'm proud to be a role model. ... But gender won't play into my day-to-day role."
31. "Patients should be able to trust that the devices they need for treatment are safe and effective," said Senator Patty Murray (D-Wash.), who initiated an investigation last year of scopes after dozens of patients were infected by them at Virginia Mason Medical Center in Seattle. The investigation found the Food and Drug Administration took 17 months to notify physicians and the public of infection risks from certain scopes used in hospitals. "Unfortunately, this investigation makes clear that current policies for monitoring medical device safety put patients at risk and, in this case, allowed tragedies to occur that could have, and should have, been prevented."
32. "One of my administration's proudest accomplishments has been expanding access to affordable healthcare to 20 million Americans," President Barack Obama wrote in an op-ed about precision medicine for the Boston Globe. "Now we're working to ensure more people will also have access to information that makes their healthcare more effective. It won't happen overnight, but we're standing once again at the doorstep of discovery."
33. "Just because you saw a season of Grey's Anatomy doesn't mean you could practice medicine," the Palm Beach County Sheriff's Office tweeted in February regarding the arrest of Malachi Love-Robinson. The event marked the second time in just over a year the then 18-year-old was arrested for posing as a physician, this time at his own medical office in West Palm Beach, Fla.
34. "It was on New Year's of last year when I got the phone call that I had cancer," Cerner Cofounder Neal Patterson said at the company's annual meeting in November. "I made a plan, got a strategy for treatment and then went to execute it. I realized God had a sense of humor: He put me in a place undergoing an EHR conversion." Mr. Patterson said he waited four hours for lab results.
35. "We have the opportunity to build a future where hospitals are as much associated with health as they are with sickness, more closely aligned in the minds of our patients with the joy of living than the fear of dying," AHA President and CEO Rick Pollack said at a summit earlier this month on the social determinants of health. The meeting was hosted by the Root Cause Coalition, which was founded by the AARP Foundation and Toledo, Ohio-based ProMedica.
36. "I remain very concerned about the rapid rate of consolidation among healthcare providers," FTC Chairwoman Edith Ramirez said in keynote address at the Antitrust in Healthcare Conference in May. "...Most provider mergers are not anticompetitive, but the few that are could cause significant competitive harm."
37. "We hope this settlement sends a strong message to covered entities that they must engage in a comprehensive risk analysis and risk management to ensure that individuals' ePHI is secure," OCR Director Jocelyn Samuels said about the $5.55 million settlement reached in August with Downers Grove, Ill.-based Advocate Health Care following 2013 breaches affecting roughly 4 million people. The event marked the largest to-date HIPAA settlement with a single entity.
38. "Usually people talk about healthcare costs in abstract terms, like they account for 18 percent of GDP. Most people know that's a problem, but no one goes to med school to change GDP," said Neel Shah, MD, an assistant professor of obstetrics, gynecology and reproductive biology at Boston-based Harvard Medical School and associate faculty at Ariadne Labs for Health Systems Innovation.
39. "If I had to make the choice today, I wouldn't go [to the Olympics]," Hope Solo, the goalkeeper of the U.S. Women's Olympic Soccer Team, said in February. "The Zika virus is definitely a concern to me. I'm obviously keeping an eye on what's going on in the news. I do know that it's spreading and they don't really have a vaccination to treat it, so it's definitely worrisome." Ms. Solo did decide to participate in the Summer Olympics in Rio de Janeiro, Brazil, although observers yelled "Zika" at her from the crowd during the opening game in response to her comments and other tweets about the virus.
40. "To the people who despair, who think their chosen profession is becoming too difficult and is failing, I disagree," said Charles Sorenson, MD, former president and CEO of Intermountain Healthcare,at Becker's 5th Annual CEO + CFO Roundtable Nov. 8 in Chicago. "We now have an unparalleled opportunity to make healthcare better for the people we serve and to make it better for the people who choose this noble profession. Each of you who are involved in healthcare have a demanding and stressful job. But when you go home, tired and spent and stressed out, ask yourself, 'What would I rather be doing?' What could be more worthwhile than caring for the thing others consider to be the most precious — their lives?"
41. "The amount of ransom requested was 40 Bitcoins, equivalent to approximately $17,000," Hollywood (Calif.) Presbyterian Medical Center President and CEO Allen Stefanek wrote in a statement after the hospital's IT systems and medical records were held for ransom in February. "The quickest and most efficient way to restore our systems and administrative functions was to pay the ransom and obtain the decryption key. In the best interest of restoring normal operations, we did this."
42. "The Pulse shooting was a horrendous tragedy for the victims, their families and our entire community," Orlando Health President and CEO David Strong said, according to the Orlando Sentinel. "During this very trying time, many organizations, individuals and charities have reached out to Orlando Health to show their support. This is simply our way of paying that kindness forward." Orlando Health and Florida Hospital, which also waived bills, saved victims an estimated $5.5 million.
43. "Nobody goes in for their mammogram if they don't know where their next meal is," Chicago-based Sinai Health System CEO Karen Teitelbaum said at the Becker's CEO/CFO Roundtable in November.
44. "Obamacare will never work," President-elect Donald Trump said during the town hall debate in October. "It's very bad, very bad health insurance, far too expensive, and not only expensive for the person that has it, unbelievably expensive for our country. It's going to be one of the biggest line items very shortly."
45. "I couldn't sleep for several weeks," Celina M. Turchi, MD, PhD, the Brazilian epidemiologist who helped connect Zika and microcephaly, told The New York Times. "It was the most important thing I have seen in my entire career. It was a tragedy, but it was like we were seeing history in front of us, day by day. It was a living history, and we were part of it."
46. "The nurse is in that room day in and day out. You give a piece of yourself to that child," said an unnamed nurse from Memorial Sloan Kettering Cancer Center as part of a photography series from Humans of New York. "But intimacy has its dangers. You have to be able to set it aside. You can't come in on your days off. You have to be able to go home at the end of the day and have a glass of wine, or go rock climbing or visit with friends. If you can't go home and rebuild, you'll burn out. You won't be able to handle the losses if you're just surviving off the wins. Because the losses are severe. You were allowed into that child's life at their most intimate time, and you were trusted. And that is a gift. And even in death, you learned something from that child that made you a better person and a better nurse."
47. "There's nothing wrong with you," an unnamed staff member at Calhoun Liberty Hospital in Blountstown, Fla., was recorded saying to 57-year-old Barbara Dawson in the hospital's parking lot after she collapsed. Shortly before Ms. Dawson collapsed, police removed her from the hospital and arrested her for disorderly conduct and trespassing. Ms. Dawson died hours later from a blood clot in her lung.
48. "Frankly, I am worried about behavioral health in this country," Chris Van Gorder, president and CEO of San Diego-based Scripps Health, wrote in an op-ed published by Becker's Hospital Review. "Only 7 percent of all healthcare dollars go to behavioral health, while one in four adults experiences mental illness in a given year. There is an inadequate supply of community outpatient resources, inadequate payment for psychiatric illness, and a shortage of qualified professionals, special skilled nursing facilities and long-term care facilities."
49. "These are our children, these are people's parents, these are our friends," Boston Medical Center CEO Kate Walsh told Becker's Hospital Review about those affected by the opioid epidemic. "This isn't happening to somebody else, this is happening to us."
50. "Now begins the process of healing," Penny Wheeler, MD, president and CEO of Minneapolis-based Allina Health said after the system reached a tentative deal with about 4,000 nurses after a 37-day strike. "This has been an emotional time for all of us, and I know that strong feelings won't vanish overnight. But I also know that every one of us — nurses and non-nurses alike — share a deep and abiding commitment to providing exceptional care to the communities we serve."
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