Marion Mass, MD
Physician Healthcare Leader Healthcare Leader of the Year
What is your current position?
Mass: I work for a children’s hospital in the Philadelphia region. Over the course of my career I have worked in the nursery, ER, pediatric urgent care, and private practice.
What is some of the advocacy work that you do?
Mass: I co-founded Practicing Physicians of America in 2017. We are a nonpartisan group that advocates for the ability of the physician to practice as they were trained, for the benefit of the patient. PPA is still going strong today and is made up of several thousand physicians. The advocacy I am involved in is to uncover the costs.
In 2019 I was one of the two co-authors on the paper, Reducing Cost and Waste in American Medicine. The paper served as the basis for the Free 2 Care paper, a bipartisan coalition of 34 member groups. We represent 70, 000 physicians and 8 million citizens. In the paper, we took a center position on healthcare. It appeared to us that everyone was either saying Medicare For All or repeal the ACA, both of which I believe are nonstarters.
PPA wants physicians to be able to practice as we were trained instead of following corporations. The paper attempted to expose corporate control and how we can allow for a more independent mindset of physicians. Physicians can start to own their own practice and speak not for corporations, but for their medical training.
What is your favorite part about your career?
Mass: It’s the quiet moments when you close the exam room door. The moments you have with families and patients when you are trying to determine how you can best impact their health in a positive manner. I am a big believer in prevention over cure. Moments where you get to make a real positive health change in the patients lives are the real wins.
What is your least favorite part about your career?
Mass: Trying to explain to or having to tell a patient that we can’t give them what they need. I think that is the crux of a lot of the problems in medicine. People use the term burnout but there is another term I think is more appropriate, moral injury. As physicians we feel as though we spend a hard four years in undergrad, a hard four years in medical school, and 3-10 years of residency. You do all of that then discover you cannot prescribe the medication that you want because it’s not on the formulary. You discover that you cannot order the CT scan because the insurance company isn’t approving it. The simple fact of trying to get into a specialist can take months.
As a physician, when you know what a patient needs and you can’t get it, it makes you pause. The people making the decisions are the people in suits. It is the people wearing scrubs who actually know what the patient needs. It is an embarrassment that despite many years of training, often, we are unable to help those we swore to serve.
What has been a moment in your career that has defined healthcare for you?
Mass: It was when I couldn’t help my own mother get the care that she needed. I was already an advocate, but when this happened it absolutely shocked me. As physicians we know how to work the system. We know what to say to be able to advocate for a loved one. When I couldn’t, it made me realize how it must be a thousand times worse for anyone who doesn’t have the underlying knowledge of someone intimate with the healthcare system.
When you are looking at someone that you love being hurt by a system you are a part of . . . that is a seismic turning point. That’s when I realized someone had to take this on not just at the level of the individual patient but at the systemic level. If it was bad for my mother who had good coverage, in a good hospital, with the ability to pay for her care, and a knowledgeable loved one who could advocate for her, how must it be for someone in a lesser hospital, with no insurance, and who doesn’t have the same knowledge base. This is a story that is playing out all over the country.
What has been the most significant moment of your career or a moment that affirmed for you that you were on the right path?
Mass: In advocacy or in medicine?
We can do both.
Mass: I guess I would say in medicine, a time where someone comes forward and tells you they trusted you enough to change their life. Sometimes it’s a long term preventative change and sometimes it’s something small and simple.
For advocacy I think my biggest moment was when I was asked to go to President Trump's September 2020 healthcare meeting. There were some things that the president did policy-wise in terms of transparency and middlemen that I supported so I went.
I was given word that he was going to do something that I didn’t agree with on surprise medical billing. I was supposed to be on the stage supporting transparency and a push against pharmaceutical middlemen. I found out there was going to be executive order on surprise medical billing that would have put more power with the corporations. I left the stage and convinced four other people to come off of the stage with me. It caused an uproar and they ended up pulling the executive order on at the final hour.
That was a shining moment in advocacy. What I would like to say about that is: what if I had said no and I hadn’t gone to that event? I personally didn’t like some of the ways in which the former president spoke, but I went to support a policy not a party or a president. When I found out there was bad policy, I left. If I had not gone we might have ended up with a really terrible executive order that would have done damage to our patients.
The lesson here is that we need to think about who we can speak for first and to make sure that we utilize our connections. You don’t know what will come out of the connections you make and the opportunities you are given.
People that have big voices have the protection of that big voice. It is the people who decide to step up without the big voices that are the real heroes.
What is one thing you could change about the US healthcare system right now what would it be?
Mass: More patient awareness about where the money is going. It has to come from the patients. They need to understand how the system works. It is obvious to everyone that healthcare is too expensive. Until we figure out why, we shouldn’t be trusting the people profiting. Unfortunately the way it works in America is that the people who have enough money lying around to throw at politicians are able to tell the politicians those convenient untruths. When you have armies of lobbyists at your disposal you can make anything sound nice.
What are your thoughts on the COVID-19 pandemic and how leaders both in healthcare and government have handled it?
Mass: I think overall it’s been really tough for everyone because we have such ready access to information on our phones. We can read so many things to try and explain what is happening but in reality any information is changing all the time because it is still new. At the very beginning of this pandemic one of the most important things to say would have been, this is going to change day to day.
All of the issues of distrust were already present in our healthcare system so it is even easier if you want to have a big voice to push on that distrust and further tribalize people. Instead of being angry when people don’t make the decision that we want, I wish we would double down on civility and grace, and to understand that our medical system was already broken.
The people that I tend to listen to are the ones that are willing to say "I don’t know." The ones who say "I’m not really sure about this." Years from now we will know more. For now what we have to try and do is to make sure that we are being clear and honest. I don’t like to say too much about COVID because there is a lot I don’t know.
What is your definition of a leader?
Mass: Someone that inspires other people to take up a just cause and has them believe that they too can be leaders. *Responses edited for length and clarity.
Some of Mass's work includes:
A doctor's persepective: Who stands for patients in the health-care debate? (www.inquirer.com/philly/)
6 medical breakdowns in my mother's care. And 1 close call. (kevinmd.com)
Op-Ed: Who should lead on the path to 'Utopia' in American healthcare? (goerie.com)