Audiobook Now Available!

We are pleased to now offer Ripple of Change in audiobook format. Please go to our Patreon page to purchase!

Listen to a sample clip from the book!


Why Our Quadruple Aim?

The American healthcare landscape is dysfunctional. Our Quadruple Aim offers insight and the courage to create significant and lasting change.

  • Health care providers are burned out and patients are frustrated
  • Target Audience: American healthcare consumer
  • Follow our blended wellness journey
  • Help us transform health care with a ripple of change

Ripple of Change Podcast Channels

Ripple of Change Podcast #17

Catch Todd and Joshua in a new Podcast!

Todd Otten and Joshua Judy are features on the VIE Healthcare Podcast focusing on the power of the caregiver-patient relationship.

Listen Now!
"I alone cannot change the world, but I can cast a stone across the waters to create many ripples."
Mother Teresa


Todd R. Otten, M.D.

Family Physician for over 20 years
Naval Flight Surgeon
Former ACO Medical Director
Former Chief of Staff
Involved with Clinically Integrated Networks
Advocate for the Quadruple Aim

Married, father of four, strong faith
Soccer player, Comic Collector
Crypto and NFT investor
Arsenal fan and golfer
Businessman and Author

Joshua J. Judy

Leader in energy industry for over a decade
University of Michigan, MS, Finance
Michigan State University, BS, Engineering
University of Wisconsin-Madison, Electric Markets
Advocate for the Quadruple Aim

Married, father of two
Music, cooking, guitar player for over 20+ years
Genealogy, videography, content creation
Master Mason, volunteering
Entrepreneur and Author

Medicine is a world of gray…

As I reflect on over 20 years of practicing medicine,
I wonder, how did we get here?  
How did the profession I love become so black and white?

I am despondent with the clerical burdens.
I am saddened by the box clicking.
I am disheartened when it’s just one more form.
I am discouraged when I hear prior auth.
I feel desolate.

Black or white?

I feel happy seeing patients.
I feel fulfilled teaching students and APP’s.
I feel content making a difference.

Black or white?

Lest we forget the patient…
Access, insurance, polypharmacy, mental health…
Providers staring at a screen.
Does data make the dying feel better?

Is this the balance we want?

I question if I am truly making a difference?
How many burned out providers does it take?
Will this crisis in medicine end?

Perhaps when healthcare leaders actually hear the voices of physicians and patients and listen.

Too often, issues in healthcare are assumed to be black and white…medicine is a world of gray.

Todd R. Otten, M.D.    2021

Our Quadruple Aim

  • Patient experience

  • Quality care

  • Lower costs

  • Provider wellness

Why is this book needed right now?

It’s simple. Everyone has been a patient–yes, even doctors and nurses get colonoscopies. We hear about the Great Resignation. The Quiet Quitting. The frustration. While health care employees have faced significant burnout during the COVID-19 pandemic, the desire to opt out of one's chosen profession is happening across many industries. Why? Are we standing before a precipice, embarking upon a chance to better understand these phenomena and its meaning? Absolutely.

Our Quadruple Aim is a four-pronged approach to delivering healthcare: Patient Experience, Quality Care, Lower Costs, and Provider Wellness. A multifaceted driver, it incorporates key stakeholders, and aligns with value-based care. When properly implemented: everyone wins. Healthcare has metastasized into a business model. Clinical leaders often play second fiddle. This has led to increasing burdens on the people actually delivering care and crushing patients financially. As a result, burnout rates are at unacceptable levels and patients are dysphoric. We believe if healthcare leaders embed Our Quadruple Aim into their culture, we could start to unwind much of the dysfunction. 

So who is responsible for delivering? Shouldn’t we all be responsible? Patients, doctors, nurses, administrations, society at large… hence the “Our” addition to the Quadruple Aim. The “Our” emphatically states that we all are responsible. Intentionally nebulous? Perhaps, but medicine is a world of gray. 

Our Quadruple Aim is an opportunity to right many wrongs through: a Ripple of Change. The book will contain evidence-based medicine, research, editorials, recent news, humor, poetry, inspiring quotes, and a blended story of healing. The intent is to motivate conversations, and the courage to speak up–not only to facilitate change in healthcare, but beyond. Our hope is that thousands cast their stone, transforming ripples into: a tsunami of change.