In my ritual of year-end reflection, I am struck by an unshakeable parallel between the general healthcare climate today, and the atmosphere surrounding the late stages of the American Revolution and the start of our fledgling nation. I’ve found myself returning to this construct as a way to organize my efforts in alignment with a sincere desire to bring about lasting improvements in the way we care for each other and promote health in our country.

I do not intend to trivialize the events and complexity of our nation’s birth, nor do I seek to elevate healthcare to an unmerited ideological loftiness. My words will reveal that at my core, I am a patriot. I served in the U.S. Navy and feel forever connected to protecting the key elements of our constitution. Many of those guiding principles were important to forming my personal mission to bring about effective, accessible care and improved health for all people. My transition away from day-to-day clinical practice toward addressing systematic enhancement of healthcare delivery was prompted by an atmosphere of disruption that I see as akin to what occurred in the late 18th century. Then, like now, there existed a pervasive air of opportunity, challenge, and responsibility that seldom occurs in a lifetime. The thoughts, experiences, and work of John Adams illustrate all of these elements well.

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