Hope, Trust, and the Future of Medicine

Matt Hollon, MD, MPH, MACP, gave his inaugural address at the WSMA House of Delegates on Sunday, Sept. 27. Read an edited transcript below, watch the video, or download the podcast (also available on Spotify and Apple).

To the leaders who have come before me and helped guide this association through challenges and into opportunities.

To my colleagues, mentors, friends, and family.

And to each physician and physician assistant in this room and across our state.
I am honored to serve as your president.

When my boys were young, there was a children’s television show called “Mouse and Mole.” It was a simple, humorous, gentle show about two housemates—a mouse and a mole—finding wisdom, friendship, and, especially, joy in the ordinary moments of life.

One of our favorite episodes was called “Catch a Falling Leaf.”

It’s autumn and Mouse and Mole head out for a walk. Mouse has shared with his friend that if you catch a falling leaf, you will have good fortune in the year ahead.

Mole becomes absolutely determined to catch a falling leaf. He devises plans. He develops techniques. He chases leaves through the forest. He works harder and harder. Yet the more effort he expends, the more elusive success becomes. Eventually he tumbles into a briar patch.

In the end, Mouse simply happens to catch a leaf while sitting calmly, observing Mole’s efforts.

You see, you don’t catch the leaf by chasing it. You catch it by being ready. By paying attention. By being present. By remaining open to possibility. And then, when the moment arrives, your hand is already outstretched.

I’ve thought about that story often over the years. I’ve thought about it as a physician, a teacher, a father, and a leader.

Because medicine—and life, of course—has a way of reminding us that there is far less we control than we might imagine. Life is inherently unpredictable. Patients do not present as described in medical texts. Illness arrives on its own schedule. Insurance companies constantly complicate the practice of medicine. And our healthcare system—if you can call it a system—is fragmented and disorganized, asking patients and clinicians to navigate this often absurd and unpredictable complexity.

The fact is the future rarely reveals itself in advance and often throws us curve balls.

Yet, every day, we are expected to show up ready. Ready to listen and learn. Ready to guide, comfort, and help. Ready to make a difference whenever possible.

That, in so many ways, is the work of doctoring. Not controlling, predicting, or commanding outcomes. But showing up-curious, prepared, attentive, compassionate, and ready when the opportunity to make a difference arrives.

And this is also the work of leadership: caring and being ready.

The question, then, is: What prepares us to show up in this way?

I believe in large part it is the stories we tell ourselves about medicine. Stories shape how we see ourselves, how students see medicine, how communities see physicians, and ultimately how our profession imagines its future. Stories prepare us for when opportunity arrives and invites us to make a difference, to lead change, to improve the “system.”

Stories matter. Narrative matters and narrative drives perception.

I am concerned that we have become too good at telling stories about what’s wrong with medicine and not nearly good enough at talking about what’s right.

No question, we recognize and experience many things that are wrong.

• Workforce shortages threaten access to care.
• Primary care remains under extraordinary strain and underfunded.
• Administrative burdens keep doctors from doctoring.
• Catastrophic economic pressures threaten practices, hospitals, and health systems.
• Scope-of-practice expansion risks undercutting patient safety.
• Public health faces mounting challenges.
• And climate change increasingly and profoundly affects the health of our patients and communities.
  These challenges matter, but they are not the whole story.

Because despite all the frustrations and headaches, medicine remains one of the greatest professional callings. What an extraordinary privilege it is to do this work. We are invited into the most important moments of people’s lives. We hear fears never shared with anyone else. We witness resilience, suffering, courage, and love. There are few professions that offer such an intimate view of what it means to be human.

We witness resilience, suffering, courage, and love. There are few professions that offer such an intimate view of what it means to be human.

And I think we should talk about that more, with students, with residents, with one another.

Otherwise, if the only story we tell is a story of burden, burden becomes all we see. If the only story we tell is a story of exhaustion, we become exhausted. If the only story we tell is a story of scarcity, we begin to believe there is never enough. If the only story we tell is a story of decline, we stop imagining a better future. And if the only story we tell is a story about what medicine has lost, we fail to celebrate what medicine still is a tremendous privilege.

One of the great privileges of my career has been working with students and residents. Every year I meet young people who are intelligent, idealistic, compassionate, and deeply committed to serving others. They remind me why I entered medicine. They remind me what is possible. And they remind me that the future of our profession is bright.

Perhaps that is why I find myself so resistant to cynicism. When I spend time with learners, I am filled with hope and I am reminded that medicine’s future is not something to fear—it is something to help optimistically shape.

I do not see generations that needs less inspiration. I see generations that deserves honesty. They deserve to know the challenges, and they also deserve to know the joy. They deserve to know that medicine remains endlessly fascinating. That medicine remains profoundly meaningful. That medicine still changes lives and communities.

And they deserve to know that there is still no substitute for the privilege of sitting with another human and trying to help. Unfortunately, there seems to be a lot of cynicism about the future of medicine—and cynicism is often hopelessness disguised.

But medicine has never been a profession of hopelessness. No, it is fundamentally the opposite: a profession of hope. Every prescription. Every diagnosis. Every difficult conversation. Every attempt to ease suffering. Each says the same thing: Tomorrow can be better.

That is hopefulness.

Hope is the decision to remain engaged and see possibility despite uncertainty. Hope is the necessary antidote to the cynicism that can arise from uncertainty. And because uncertainty is always present, trust is essential.

Which brings me to another challenge facing our profession.

We live in an era in which information has never been more abundant and trust has rarely felt more fragile. Misinformation and disinformation increasingly impact how people understand science, expertise, health, and even reality itself. Despairingly, there are organized efforts to undermine trust in professions, institutions, expertise, and knowledge.

And yet I see tremendous opportunity here, because trust has always been the currency of medicine. Patients do not trust us because we are perfect. They trust us because we care, we listen, we are honest, and we remain committed to seeking the truth.

The antidote to misinformation is not simply more information. It is trusted relationships. One patient at a time. One conversation at a time. One community at a time.

And, trust does not require us to know everything. The truth is patients rarely expect us to know everything. What they hope for is something both more realistic and more profound. They hope we will bring our knowledge, our experience, our judgment, and our humanity to bear on whatever uncertainty lies before us. They hope we will be honest about what we know, humble about what we don’t, and steadfast in our commitment to finding the best path forward together.

One of the things I love most about medicine is that it rewards this humility. The longer you practice, the more comfortable and honest you become in the uncertainty of not knowing.

Great physicians are not defined by certainty. They are defined by curiosity. And, curiosity is humility in action. It keeps us asking better questions, listening more carefully, and growing throughout an entire career.

Great physicians ask the right questions and revise assumptions. They listen and learn. They are willing to change their minds when evidence changes. They are humble. And in a world filled with uncertainty, this humility may be one of the most powerful gifts physicians have to offer.

Perhaps one of the true joys of being a physician is humbly remaining worthy of the trust our patients place in us. Over time, that trust becomes something even more precious-it becomes respect. And with that respect comes influence: the opportunity to help patients, communities, and the public find their way through uncertainty, misinformation, and disinformation. That influence is not simply a privilege. It is a responsibility.

And that responsibility is stewardship, stewardship that extends beyond the exam room. Stewards of knowledge. Stewards of our healthcare ecosystem. Stewards of our communities. And, stewards of our home planet.

We care about the conditions that enable people to be healthy. Clean air, clean water, safe housing, education, public health, strong communities, a healthy planet. And we must continue to vociferously communicate that the health of our patients cannot be separated from the health of our communities and the planet itself.

Here in the Pacific Northwest, and across the globe, threats to planetary health threaten human health. We have watched our summers transformed by smoke and horrific fires. We have experienced unprecedented heat. We have watched forests, rivers, farms, and ecosystems deteriorate under stress. As physicians we must recognize these are not simply environmental observations. They are health observations.

And these are not future concerns. They are current realities.

Yet, even here I remain hopeful and optimistic. Paraphrasing Martin Luther King, “In the face of finite disappointment, hope [and optimism] are infinite.”

Because optimism is not a prediction. It is a choice. A choice to remain engaged. A choice to continue showing up. A choice to believe that our actions matter. A choice to advocate not only for the patients in front of us but also for the conditions that will allow future generations and our planet to thrive. Optimism is the fuel of stewardship.

Because optimism is not a prediction. It is a choice. A choice to remain engaged. A choice to continue showing up. A choice to believe that our actions matter.

And stewardship isn’t simply about the positions we take or the policies we support: It is ultimately about how we choose to show up for one another. In my experience, nearly everything meaningful in medicine, and life, begins with showing up for one another.

That is what physicians and physician assistants do so well. We show up and we build relationships.

Our greatest influence comes when we earn the opportunity to walk alongside others-our patients, learners, colleagues, legislators, and communities—as we seek the right path together.

And, it is through these relationships we create the real possibility for change. These relationships are the engine of change, and our Washington State Medical Association is indispensable to that end.

Not simply because we advocate. Not simply because we educate. Not simply because we convene. But because we connect. In an era when many feel professionally isolated, WSMA is our professional home. It’s where we realize we are not alone. Where we share wisdom. Where our ideas become action. Where we form friendships. A place where we remember that we are better together.

The greatest strength of the WSMA and like-minded organizations is not policy: It is people. Relationships. Community. A community of physicians and physician assistants from different specialties, practice settings, political perspectives, and life experiences that share a common purpose: We care about patients. We care about our communities. We believe health matters. We believe we have a critical role to play in shaping the future.

And so, my hope for this year and our future is straightforward.

That together we will advocate courageously and strengthen the physician workforce.

That together we will reduce unnecessary burdens that keep us from doctoring and defend the physician-patient relationship.

That together we will speak clearly on behalf of public health and continue to earn trust.

That together we will help build a healthier future for our communities and our planet.

And above all, my hope is that together we tell the full story of medicine. Not just the hard parts, the whole story. The story of purpose, meaning, curiosity, trust, service, community, stewardship … and, especially, the story of joy.

In many ways, every theme I have touched on this morning-hope, trust, humility, curiosity, stewardship, and community-ultimately points back to joy. Because joy is not the absence of difficulty. Joy is choosing curiosity over cynicism. Connection over isolation. Hope over despair. Joy is engaging with the world despite its imperfections. Joy is believing that our work matters.

Because it does.

And here is the lesson: We won’t catch a falling leaf by chasing it. We must be ready-ready with curiosity, courage, humility, compassion, and hope. Ready to prioritize joy, take up space, practice solidarity, organize, and demonstrate courage.

This is how we will be ready when the leaf begins to fall.

Ready for the moment. Ready for one another. Ready for the opportunities that have not yet revealed themselves. Ready to continue the rewarding work of caring for our communities. Ready to embrace the extraordinary privilege of being physicians. Ready to tell the stories that inspire the next generation. Ready to extend our hands. And ready to help.

Thank you for the opportunity to serve you, our patients, and our profession.

Thank you for the work you do every day.

And thank you for helping write the next chapter in the story of medicine in Washington state together. Thank you.

Matt Hollon, MD, MPH, MACP, is WSMA’s president.