For specialists like myself, this does not mean our roles become less important. On the contrary, our responsibilities become more comprehensive and strategic. We are involved in every stage of patient care-from prevention and early detection to surgery and recovery. In colorectal care, for example, this could mean increasing the use of screening colonoscopies, better management of precancerous conditions, and creating coordinated follow-up plans with primary care doctors and nutritionists.

The Essential Role of Preventive Medicine

Preventive care is the foundation of any successful value-based system. Yet, in the U.S., it remains underused. Despite strong evidence supporting the effectiveness of screenings and lifestyle interventions in preventing serious diseases, many patients only seek care when symptoms become severe.

This delay not only jeopardizes lives but also increases costs. Treating late-stage cancer is far more expensive than removing a precancerous polyp during a routine screening. Similarly, managing complications from diabetes in the ER is much more costly than providing proactive counseling on nutrition and exercise. We can and must do better.

Barriers and Opportunities

There are challenges to implementing value- based care, such as fragmented data systems, the persistence of the fee-for-service model, and misalignment between insurers, providers, and policymakers. However, we also have significant opportunities. Advances in digital health tools, population health analytics, and integrated care models can help bridge these gaps.

But more than technology, what we need is a cultural shift. We need to redefine what success in healthcare looks like-not by the number of surgeries performed, but by the number of lives improved and diseases prevented.

A Surgeon’s Call to Action

As a senior surgeon nearing the end of my active clinical career, I feel a strong sense of responsibility- not only to my patients but also to the future of healthcare. We must embrace value-based care-not simply as a policy shift, but as a moral imperative.

Let’s invest in prevention-not just because it saves money, but because it saves lives. Let’s reward care that heals, not just care that treats. And let’s work together to build a healthcare system worthy of the trust our patients place in us every day.

The future of American healthcare depends on it.