The hidden message that shaped Dr. Thad Schilling's approach to primary care

Early in his career as a primary care physician, Dr. Thad Schilling was working at home when his 5-year-old daughter walked in and handed him a note that read, “Daddy, I wish you didn’t have to do charts.”

The message hit Schilling hard. He was balancing patient care with raising a young family, often spending his evenings and weekends catching up on patient charts. 

Around the edges of his daughter’s note, she had repeatedly written the word “love” in crayon. A few of the letters were transposed, as children’s letters sometimes are, and something caught Schilling’s eye.

At the bottom, instead of seeing love, Schilling saw a different word: evolve. 

“That, to me, was a message about the need for evolving,” he said. 

The note became more than a family keepsake. It helped crystallize a challenge Schilling had already begun to see in medicine: caring for patients could be deeply rewarding, while the way the work was structured often made it difficult for a primary care doctor to sustain that work over time.

Today, as CEO of Optum Massachusetts, he continues to be guided by that experience in his efforts to better support clinicians in primary care. 

Growing up in a small town in Ohio, Schilling developed an early fascination with science and biology. He initially planned to pursue a career in scientific research and even completed a college senior thesis on cancer and cell cycle regulation.

Spending a summer working in a laboratory helped him realize that while he loved science, he wanted a more direct connection with people. Medicine offered both.

He eventually settled on primary care, drawn to the opportunity to build long-term relationships with patients through different stages of life. 

While training in Boston, he became interested in population health and value-based care, where improving health outcomes takes priority over the number of patients a practice sees. 

But practicing medicine also exposed him to its challenges.

“I want to practice for 30 or 40 years,” he remembered thinking. “It can’t be this bad. We have to make this better.” 

Then his daughter wrote that note.

For Schilling, the note made a familiar professional challenge deeply personal.

“Primary care is an all-encompassing job,” he acknowledged. 

Administrative demands can extend a clinician’s work well beyond time spent with patients. In Schilling’s case, his daughter could see how much time he spent completing charts at home.

Her message helped strengthen his commitment to improving the experience for other clinicians, too. 

“We have to do things differently,” Schilling said. “So, I committed myself to helping be part of the solution.” 

Schilling's own struggle to balance work and life sparked his interest in redesigning how doctors and care teams meet patients' routine health needs. As his leadership responsibilities grew, so did his opportunity to help improve support for both clinicians and patients.

“Part of my job is helping evolve the healthcare system to help sustain primary care doctors in their work,” he explained.

Schilling points to strong, interdisciplinary teams as one way to better support clinicians and their patients in primary care settings. Those teams can bring together doctors, nurse practitioners, physician assistants, nurses, medical assistants, clinical pharmacists and integrated behavioral health clinicians. 

“Creating robust teams is one solution,” he said. Together, those professionals “can provide even better care than one individual physician.” 

It is an approach connected to Schilling’s earlier leadership work. At Reliant Medical Group, now part of Optum, he helped pioneer a move toward patient-centered, team-based care, bringing together clinicians across disciplines to improve quality and efficiency.

Schilling is also encouraged by innovations like AI tools that can improve workflows and reduce administrative burdens. By helping streamline routine tasks, these technologies can give clinicians more time to focus on delivering high-quality, personalized care while preserving time outside of work.

One example is a chart summarization tool that brings together clinical information from multiple sources and highlights key details in the medical record. By reducing the time clinicians spend reviewing charts, it can help them better prepare for visits and spend more time focused on the patient in front of them.

For Schilling, the goal reaches beyond improving the experience of clinicians practicing today.

“There’s this effort that all of us in healthcare and leadership are making,” he said, “to try to make the conditions better and easier for our next generation of caretakers.” 

That next generation is also personal for Schilling. His son, Mac, is interested in becoming a physician. 

For a doctor whose own career was changed in part by a message from one child, watching his other child consider a career in medicine brings the story full circle.

“I’m really optimistic about the future for him,” Schilling said. 

Years after his daughter's handwritten message, the word he discovered still captures the work ahead: evolve.

Not simply to change healthcare, but to create a future where clinicians can spend more of their time caring for people, which is what drew many of them to medicine in the first place.