Sometimes on Wednesday afternoons at the clinic I supervise medical residents who take my breath away because of their wonderful qualities: young, eager, hungry for answers, and totally immersed in the flow of patients streaming in the door. The residents’ experience is mixed. Their hands-on clinical education is as valuable as it gets, but the obstacles thrown in their way by our fractured health care system are frustrating and infuriating.

Here’s an example. My very first day, I discovered that the clinic follows the same chronic illness care model for treating diabetes patients that Ed Wagner, M.D., developed at Seattle’s MacColl Institute for Healthcare Innovation through our national program Improving Chronic Illness Care. I thought, “This is great!” The clinic’s doctors have the model down cold: they cluster diabetes patients in a special registry, they track real-time key indicators and they proactively manage each patient’s care, one-on-one.

Working as a team, getting up-to-the-minute hard data, focusing on the patient—what these residents and attending physicians do inside the clinic’s self-contained world is how our entire health care system should work. But when these same doctors reach outside the clinic, too often there is no matching place to plug into. And the outcome? Much of the clinic’s good work is stymied because there are too few health care professionals responding to patients’ needs the way that the clinic does.

After watching one resident spend a half-hour on the phone trying to get just one patient one appointment with one specialist, I thought: “Nothing’s changed in all these years. How in the world can these doctors take care of patients if so much of their time and energy is chewed up fighting a system that seems hell-bent on making their job harder, not easier?”

Irritated, I got in my car and drove back down Route 1 more committed than ever to the bedrock principle that guides everything the Robert Wood Johnson Foundation does. This principle tells us that we are the stewards of private resources that must be used in the public’s interest—particularly to help the most vulnerable in our society. This is our moral compass; it helps keep our mission, our ethics and our passions on True North.

Nothing exemplifies the Foundation’s powerful commitment to the public’s interest more than how we invest our resources to change America’s troubled health care system until it finally—and reliably—delivers a level of quality care that meets the public’s expectations of what they need and deserve.

In other words, the next time that resident picks up the phone, someone will answer who actually knows what to do and how to do it, and together they can improve the health of that patient by delivering the right health care at the right time in the right way.

For the doctors, nurses and patients at the clinic in New Brunswick—and for me—that would be a pretty good definition of “quality” health care that most certainly would stand the test of time.

But how do we get there? How do we move from the system we have to the system we need? What obstacles stand in the way? How do we overcome them? And what will health care look like when we remove them?