People, process and technology must be brought together in harmony to create stable human-centered healthcare systems. Part one of this article focused on the process and technology components. In part two I’ll review some of the people issues that make healthcare uncaring.

The challenges for healthcare professionals to act caringly are many and varied. A national 2026 survey of physicians found:

• 47% often or always felt unable to provide optimal care due to time pressures
• 44% were unable to deliver medically necessary treatment because insurers blocked it
• 45% often or always felt unable to provide the best possible care due to corporate constraints
• 68% experienced moderate or severe distress because profit‑driven systems prevented proper care.

The profit motive can be almost irresistible and even coercive, leaving patient’s needs overlooked or their dignity violated.

Consider the case of Harry, hospitalized after a diagnosis of Gillian Barre Syndrome (GBS). After several rounds of periphrasis, he was scheduled for discharge to a top specialty rehabilitation center. The hospital did not want to lose this profitable procedure for a patient with good insurance, so a physician leader convinced Harry he was better off receiving rehabilitative services in the hospital, closer to his care team, in case he suffered a setback. He also warned Harry that transport back to the hospital would cost thousands of dollars in out-of-pocket expense. The physician’s arguments were not false, but because the probability of these events was extremely low the advice was not necessarily in the patient’s best overall interest. Frightened, Harry opted for hospital rehab. Harry’s sub-optimal inpatient treatment resulted in a poor patient experience and suboptimal outcomes compared to what he might have experienced at a specialty rehab that specialized in GBS recovery.

After discharge Harry was referred to a neurologist to receive Immune Globulin Infusion (IVIG) treatments, but the neurologist refused to begin treatment until he performed all the tests already performed by the hospital, citing he only trusts his own testing. Perhaps, the real motive was that duplicating those tests was profitable. After performing the tests, the neurologist left for a three-week vacation. The delay in diagnosis and treatment led to Harry suffering a GBS relapse which required an avoidable, costly, and risky re-hospitalization.

Profit motive affects patient care often, consistently, and structurally — not as an occasional distortion but as a defining feature of the U.S. healthcare system. But Harry’s case reveals another uncaring characteristic of the healthcare system, unnecessary treatment and testing.

A nationwide analysis of one billion outpatient claims conducted by Medicare and commercial insurance companies found up to 51% of common lab tests were performed more often than guidelines recommend, and 24% of all tested individuals received excessive testing (14.4 million people).  The study identified excess testing for just four tests (Vitamin D, PSA, lipid panel, HbA1c) cost over $350 million per year. Extrapolating these five tests to all lab tests Medicare wasted $1.95–$3.28 billion in 2019.

Harry’s case also illustrates the widespread problem of clinicians behaving dismissively toward patients. A large meta‑synthesis of 11,000 patients found that when clinicians ignore, minimize, or dismiss patient’s expressed concerns, it can result in delayed diagnosis and treatment, worsening medical conditions, and diminishment of the patient’s dignity. Harry’s physician demonstrated little compassion even though his diagnosis was dire.

Sometimes dismissive behavior is experienced more by minority groups due to systemic and personal racial bias.

Consider the case of Sherry, a poor black female whose two-year-old daughter (Beth) was diagnosed with a chronic ear infection. On six different visits to the pediatrician Sherry urgently explained that Beth’s symptoms suggested something more serious than an ear infection, but the pediatrician dismissed Sherry’s concerns and attempted to make her feel dumb for challenging a professional diagnosis. Sherry felt the familiar nuance of racial bias and sought a second opinion, finding that her daughter had pneumonia, had lost 75% of her lung function and was only days away from dying.

52% of Black patients report their pain is not taken seriously. A Kaiser Family Foundation survey found that 42% of Asian adults and 51% of Hispanic adults feel they must prepare for insults, change their appearance, or brace themselves emotionally before seeing a healthcare provider.

Medicine often defines “normal” using data drawn from majority populations. When those standards are treated as universal, patients whose physiology falls outside those norms are at greater risk of being misunderstood, misdiagnosed, or inadequately treated. Clinicians should consider the physiological differences between ethnic or social groups. For example, pulse oximeters are 3 times more likely to miss low oxygen levels in black patients due to skin pigmentation. Black patients face 4 times higher odds of misdiagnosis than White patients. Black women are 3-4 times more likely to die from pregnancy related causes.  Information technology might help in this area by verifying that diagnostic technology adjusts for diverse groups and physiologies.

Healthcare organizations must hire, train, and retain strong caring and empathetic people because such individuals are more likely to pursue the good of patients even when misaligned incentives and inefficient systems don’t encourage it. CIOs, as sensing agents, should align themselves with the best of these professionals to jointly advocate for needed changes in processes, technologies, and policies.

Volumes could be written about the people causes of uncaring healthcare, but I will end this piece saying CIOs and their teams can perform a valuable function of environmental sensing and technology innovation to make healthcare more caring. Patients first!