From Crisis Mode to Collective Cure
A Conversation with Dr. Monica Wang
By Sarah Bliss Matousek & Rosemarie Day
Most health system leaders start their week staring down a list of crises: tight margins, workforce burnout, regulatory pressure, the patient surge at the front door. And somewhere on a back burner sits the thing many of them genuinely believe in: working on the upstream drivers that make people sick in the first place.
So how do you actually act on that conviction when the fires are everywhere?
That’s the question we brought to Dr. Monica Wang, public health expert and leader, and author of Collective Cure. The conversation moved past familiar talking points about social determinants and into something more practical: how leaders can begin shifting their own organizations toward upstream thinking without pretending they can solve every structural problem alone.
Why “Collective” and “Cure” Belong Together
The title of Dr. Wang’s book puts two big ideas in deliberate tension. “Cure” is what health systems are built to deliver: clinical care, procedures, individual treatment. “Collective” reflects the broader conditions that shape health outcomes before patients arrive in care settings: housing stability, transportation access, environmental conditions, economic opportunity, and systemic inequities.
Too often, these conversations operate in parallel rather than together. Dr. Wang argues that clinical excellence alone cannot offset the structural conditions driving poor health outcomes and avoidable utilization. At the same time, health systems do not need to solve every societal challenge independently to play a meaningful role. Instead, healthcare organizations can use their scale, influence and convening power to participate more intentionally in cross-sector solutions.
From “It’s Not My Job” to “This Is My Role”
Here’s the sticking point most leaders hit: they understand intellectually that social and structural factors drive health. They just can’t find their footing in it. The mental traps sound like this:
“We only control a small slice of what makes people healthy.”
“We’re already overwhelmed.”
“Isn’t housing, education, and labor someone else’s job?”
The framework Dr. Wang offers gives leaders a productive way through that impasse. Three moves stand out.
1. Reframe the Question: From Ownership to Contribution
Rather than asking, “Is this our responsibility?” organizations can ask: “What is my contribution to this problem and to its solution?”
This shift helps organizations:
avoid overcommitting to problems they cannot solve alone,
avoid disengaging from upstream issues entirely,
and clarify where healthcare institutions can lead, partner, convene, or invest strategically.
For many systems, this creates a more sustainable framework for community health work that aligns with operational priorities rather than competing against them.
2. Use Bridging as an Operational Strategy
Dr. Wang describes “bridging” not as a soft leadership concept, but as a practical approach to partnership-building and decision making.
In practice, bridging happens across three dimensions:
Sectors: healthcare, public health, housing, education, labor, transportation, community organizations.
Perspectives: executives, frontline staff, patients, and the communities most impacted.
Values: anchor in shared motivations: safety, dignity, opportunity, family stability rather than ideological differences.
3. Start with Two Lenses You Already Have
One of the most useful parts of the conversation was Dr. Wang’s reminder that leaders already experience these issues personally and organizationally.
Themselves as patients and family members. Leaders aren’t outside the healthcare system. They move through it with their own families. That lived experience is data. It helps leaders understand how structural barriers show up in real life, not just in dashboards.
Their workforce. Housing instability, childcare gaps, transportation challenges, and neighborhood safety aren’t just patient issues. They show up as turnover, burnout, absenteeism, and scheduling chaos in your own organization. Framing upstream work as a workforce health and stability issue connects directly to what boards already care about.
What to Do on Monday: Four Concrete Steps
The pandemic era left a lot of health leaders saying, “We can’t go back to business as usual.” The question is what you’re actually doing differently. Drawing from the conversation, here are four concrete starting points:
1. Map One Place Where You Already Have Skin in the Game
Ask your team: “In which neighborhood or community do we have the deepest footprint and the highest stakes?” Pull your admissions data, your ED patterns, your workforce zip codes, your community benefit reports. Find one geography where you serve many patients and where a significant portion of your staff lives. That’s your starting point.
2. Build a Small Cross-Sector Working Group
Within 30 to 60 days, bring together a local FQHC or primary care partner, a community-based organization with real local trust, a representative from housing or public health, frontline staff from your own organization, and, if possible, community members from that geography.
The initial objective should remain narrow and achievable: Identify one of two specific local challenges that partners can address collaboratively over the next 12-18 months.
3. Start With One Workforce-Connected Issue
Pick one tangible issue affecting your staff in that same geography: transportation barriers for night or early morning shifts, childcare gaps, unsafe routes to work, housing instability.
Name it as a strategic priority, not an HR side project. Ask your cross-sector partners: “Which of us can help address this, and what can each of us bring?” This is bridging in action.
4. Measure One Visible Outcome and One Learning Goal
Avoid launching overly broad, multi-year initiatives without near-term accountability.
Instead, define:
One visible operational change
One measurable learning outcome
Examples may include:
A transportation partnership
A childcare support initiative
A targeted housing collaboration
Changes in avoidable ED utilization
Workforce retention improvements in a specifi unit
This creates clearer visibility for boards, leadership teams, and staff while building organizational learning over time.
The Leadership Shift
What came through clearly in this conversation is that the real test for health leaders isn’t whether they can articulate the social determinants of health. Most can. The test is whether they can bridge across sectors and values, clarify their specific role without abdicating or overclaiming, and act locally and concretely, starting with the communities and the workforce they already know.
The question is no longer, “Do you care about upstream factors?” The question is: What will you do on Monday to prove it?
You don’t have to map the first move alone. Day Health stands ready to help you find the geography, build the cross-sector working group, and define the near-term outcomes that turn conviction into action.
Dr. Monica Wang’s book, Collective Cure, is available now. Learn more at monicawangphd.com.