In this episode of Adoctor’s Journey, I had the privilege of sitting down with Dr. Todd Otten; a family medicine physician, military veteran, and passionate change-maker in the healthcare space. As Co-Founder of the Our Quadruple Aim movement and co-author of The Ripple of Change, Dr. Otten’s journey reflects what happens when experience, empathy, and bold vision intersect.

Leadership at 30,000 Feet

Dr. Otten’s path into medicine began with a love for connection and community, first discovered during his time in parks and recreation. But it was in the U.S. Navy, serving as a Naval Flight Surgeon, where his leadership journey truly took off. In a role that many might assume involves surgical aviation heroics, Dr. Otten instead found himself responsible for the primary care and psychological readiness of entire flight crews. Imagine being the only physician for 500 personnel, making decisions with life-or-death implications, no room for second opinions.

This experience instilled in him a rare leadership quality: the ability to act decisively, lead collaboratively, and trust deeply.

“You learn to lead in the absence of backup. You rely on your corpsmen. You learn the value of systems, and where medicine can fall short without them.”

Systems Thinking in Healthcare

That last point stuck with him. In aviation, checklists are sacred, a proven safeguard against error. In medicine? Not so much.

Dr. Otten sees opportunity here: what if healthcare embraced checklists and systems thinking as rigorously as aviation does? He references The Checklist Manifesto and supports building a national safety database where healthcare professionals can report errors or concerns without fear, mirroring aviation’s culture of transparency.

The Quadruple Aim Reimagined

But Dr. Otten’s most transformative work comes through the Our Quadruple Aim movement. You’ve likely heard of the Institute for Healthcare Improvement’s Triple Aim, focused on population health, cost, and patient experience. But something was missing: the caregiver.

In 2014, physician wellness was added to create the Quadruple Aim, a shift that resonated deeply with Dr. Otten.

“Without provider wellness, everything else falls apart. You can’t deliver exceptional care if the people delivering it are burned out.”

He became a “cheerleader of one,” championing this cause in every meeting, every boardroom, every clinic conversation. Over time, his efforts gained traction, turning solo advocacy into a movement for humanizing healthcare from the inside out.

Burnout as a Catalyst for Innovation

Dr. Otten doesn’t shy away from talking about burnout, dysfunction, or the cracks in our system. But he doesn’t stop there. The Ripple of Change, the book he co-authored, isn’t a complaint, it’s a roadmap. It’s about using our frustrations not as endpoints, but as starting lines for innovation.

His approach is simple yet radical: support the providers, and everything else will improve—patient outcomes, cost efficiency, team morale, and long-term system sustainability.

Final Takeaway

The conversation with Dr. Todd Otten was more than inspiring, it was a call to action.

As leaders in healthcare, we must stop treating burnout as a symptom and instead recognize it as a signpost pointing us toward the need for structural transformation.

From military precision to grassroots leadership, Dr. Otten’s journey teaches us that real change begins with courage, connection, and a checklist or two.

What part of Dr. Otten’s story resonated most with you? Are we doing enough to support the humans behind the stethoscopes? Let’s talk. Drop your thoughts below or share this post to keep the conversation going.

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