Credibility and Influence in the Healthcare Field

Tonight I had the rare opportunity to take some significant downtime and enjoy dinner at a cozy, sophisticated neighborhood restaurant in the Mount Pleasant area of DC - Tonic.

I like to read on the rare occasions I eat alone. Although I had some work-related materials in my bag, I was interested in reading some local coverage.

On my way in, I picked up a new (to me) newsprint publication - The Washington Blade.

After I picked blackened catfish and collard greens (excellent choice) from the menu, I spread out the two publications I'd peruse during dinner:

1. A Harvard School of Public Health Center for Continuing Professional Education "Forces of Change" brochure (I'm considering attending the September 2008 Seminar for New and Emerging Leaders) = dry informative read.

2. The December 14, 2007 edition of The Washington Blade = juicy educational read.

I read the Harvard brochure through dinner, circling the seminars I'd find most valuable and writing notes in the margins.

After I ordered bananas foster, however, I dug in to The Blade, having no idea what to expect.

I was a few pages in, ruffling the pages and harrumphing at the commentary, deeply engrossed in a piece covering Dana Beyer's withdrawal from the race to replace a Maryland state legislator who passed away unexpectedly (Delegate Jane Lawton), when I realized The Blade is a WGSX (women/gender/sexuality) friendly-publication.

Beyer was among 7 candidates seeking support from Montgomery County Democratic Central Committee party officials. She was the only GLBT (gay, lesbian, bisexual, transgender) candidate in the running.

Beyer is a retired physician with policy experience; she currently works for Montgomery County Councilmember Duchy Trachtenberg. Last month she assisted in the passing of a measure preventing discrimination in bars against people who are transgendered.

We missed the chance for hearing the platform of a candidate with a unique skill set.

Beyer would have been "the nation's first transgender state lawmaker."

The MCDCC chose instead a candidate who placed 7th last year in the competition for 3 District 18 seats - Al Carr, a Kensington town Council member who garnered 8 percent of the votes. Beyer placed fifth, winning 12 percent of the 41,500 votes cast.

What does Beyer's story, and her withdrawal from the running (along with her continued commitment to "stay in the mix"), have to do with credibility and influence in the field of healthcare?

My immediate recognition of the Harvard brochure as a credible, worthwhile read is symbolic of how we treat "credible" and "influential" figures in the hospital/healthcare field.

Physicians, policy makers, administrators, lawyers - these are credible individuals, whom we trust to deliver 'important' news and influence the changing face of the healthcare marketplace.

Patients however, are personas non grata - especially consumers with chronic conditions.

Especially those with conditions we view with skepticism (sometimes rightly so), such as migraine headache disorders. Especially patients who present deep knowledge of their own healthcare issues, strong treatment preferences, and a long experience managing their personal wellness.

Patients, in short, are not viewed as 'credible' participants in designing our best-practice care processes. We currently lack the influence to push significant change in the healthcare field.

Even in the blogosphere, the democratic, "open-marketplace" forum for healthcare debate, this dichotomy exists...who are the most famous (or infamous) healthcare bloggers? Docs. Consultants. Hospital Administrators.

Whose blogs, although insightful in the extreme, revelatory in nature, and often painful to read, are most often left off the blogrolls (including mine)?

Those focusing entirely on a patient's perspective.

Do you view your patients as some of the most credible witnesses to your efficacy? Do you indoctrinate the wisdom of these witnesses at every level of your organization, including the Board of Directors?

Do your patients have influence?

College and university faculty members' review for tenured positions often involves student evaluations. How do you weight patient evaluations of physicians? Your facilities? Ease of use and comfort of care?

The blogosphere and the Health 2.0 movements offer a little-replicated, time-limited opportunity for broadening the debate around how to grow an efficient, effective healthcare system.

Like similar pivotal points in history (the rising power of employer unions and 'organized' labor resulting from the industrial revolution), we have a short time to harness the wisdom of crowds and recognize the growing collective power of an increasingly vocal and involved user-base.

Carpe diem.

All we have to do is open ourselves to perspectives of populations the market currently derides as 'the others.'

And then incorporate their recommendations into strategic planning...small-order tasks for an industry that has built gospel on the basis of expert influence.

Let's give some weight, finally, to those who actually have credibility gained via their use of healthcare and hospital services.