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Even as politicians and pundits continue to debate the merits of the Affordable Care Act (ACA), it is time to look beyond it to the next phase of US health care reform. Although many physicians contributed to the development and implementation of the ACA, the forces that have steered it so far have been primarily governmental. Leaders from within health care should now more firmly take the tiller. To borrow a phrase contributed by Splaine and colleagues,1 it is time to move from change forced from the “outside in” to change led from the “inside out.”
Berwick DM, Feeley D, Loehrer S. Change From the Inside OutHealth Care Leaders Taking the Helm. JAMA. 2015;313(17):1707-1708. doi:10.1001/jama.2015.2830