Efficiency Isn’t Enough: Why Healthcare Needs More Than DOGE
“DOGE” has gone from a literal to figurative four letter word, and with good reason. Yet nobody would argue that healthcare as a whole in the United States is expensive, inefficient and ineffective, and when compared to our peers, woefully behind.
Healthcare expenditures per person in the U.S. were $12,555 in 2022, which was over $4,000 more than any other high-income nation. And the average amount spent on health per person in comparable countries ($6,651) is about half of what the U.S. spends per person. Global health indices show that the U.S. ranks low in overall population health, last overall among other high-income nations.
The care provided in the U.S. is distributed heterogeneously, leaving huge gaps, and the quality is of varying levels. The principles of DOGE — improve efficiency and efficacy — can be applied to healthcare, but with the surgical precision of the scalpel rather than the blunt sword.
The Changing Healthcare Workforce
Physicians are increasingly not the face of direct patient care, as the physician shortage is amplified with increased demand due to a larger, older and sicker population. The American Association of Medical Colleges (AAMC) projects a physician shortage between 37,000 and 100,000 by 2033. Compounding this problem is the current state of healthcare access in the US — research has shown that up to 80% of U.S. counties qualify as “healthcare deserts,” meaning they lack proper access to the services needed for their residents to maintain health.
The void is not being filled by physicians. Rather, non-physician providers are stepping up, including pharmacists, nurse practitioners, physician associates, and nurses, all practicing at the top of their licenses.
State legislatures are aware of healthcare worker shortages and are slowly addressing the issue. In 2024, 34 states enacted over 120 bills that address scope of practice and prescriptive authority for health professionals. In addition, there were more than 160 bills introduced across the nation related specifically to pharmacist scope of practice expansion. The expanding Nurse Licensure Compact (NLC) streamlines RN licensure, now allowing nurses to practice in 42 states with a single license. More than half of U.S. states now offer full practice authority for nurse practitioners, letting them practice without physician supervision.
Physician associates and nurse practitioners in particular are carrying more of the load, as their professions are expected to grow 28% and 40% over the next decade, respectively, as the physicians dwindle.
Hidden Barriers to Workforce Activation
Unfortunately, in order to activate this workforce, practitioners and their employers must navigate a labyrinth of local, state and federal regulations. Until recently, managing the licensure of these workforces required a dedicated operations team, outsourced legal oversight, and continued scrutiny of multiple regulatory bodies with sporadic rule changes.
This is a problem that Zivian Health is solving. Zivian’s mission is to transform a challenged healthcare workforce into a superpowered one — our digital solutions provide an easy button for workforce activation and regulatory compliance, expediting arduous administrative burdens and removing unnecessary barriers to care without exorbitant operational and legal fees.
Zivian’s tools for compliance, quality oversight, and licensing are being used to create more efficient and scalable care models, so that medical practices can stay compliant with minimal effort and remain focused on the serious task of expanding access to high-quality healthcare.
Efficient and Equipped
But solving compliance is only a partial solution, as the training of non-physician providers is highly variable. Standardizing and elevating clinical knowledge across a decentralized, fast-growing workforce is mission-critical to meeting patient needs, reducing liability, and increasing productivity.
This is where Zivian Health steps in once again — not as a compliance ally, but as a clinical performance accelerator. Zivian’s education solutions are purpose-built for the needs of today’s growing non-physician workforce, from curated onboarding pathways to just-in-time (JIT) clinical refreshers and fully customizable learning modules.
In fact, Zivian has recently developed DOSE (dopamine, oxytocin, serotonin, endorphins) — a proprietary, AI-assisted methodology for creating impactful learning experiences. The DOSE approach delivers dynamic, adaptive content in formats that maintain engagement, improve knowledge retention, and align with the realities of clinical work.
Why does all of this matter?
While there are fundamental problems with DOGE, its conceptual focus on workforce efficiency resonates deeply within healthcare. Zivian Health exists to operationalize that very principle — not through indiscriminate cost-cutting, but through smart and scalable innovation. In the face of mounting physician shortages, regulatory complexity, and widening care disparities, Zivian Health is building the infrastructure to support an agile and productive workforce. In this way, we’re building a future where leanness and efficiency enhances—not compromises—quality, access, and patient outcomes.
Rafid Fadul, MD
Co-Founder/CEO, Zivian Health
