Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions. 

Politics: How Taking the High Road Can Benefit Healthcare

5/19/2016 3:37:37 PM | 7 comments

In a 2014 poll of the most prestigious professions, doctors ranked first with an 88 percent approval rating. Nurses were also in the top 10. And while physician assistants or nurse practitioners weren't specifically mentioned, I know from experience that we enjoy a fair amount of esteem as well.
 
Being in a respected profession carries a certain level responsibility. When our State Congressman asked me to read the Affordable Care Act (ACA) and offer my professional opinion, I was excited to help. When friends and family raise questions about healthcare reform, I'll happily oblige.
 
But it goes beyond medicine. Sometimes the degree of faith people place in my opinion surprises me.
 
"Where should I buy a house?" friends will ask. (Believe me, I am the last person you want advising your speculative real estate ventures.)
 
Or, "What college should my daughter apply to?" (The answer is the University of Minnesota, of course.)
 
Then the 2016 election year rolled around in all its rhetoric-laden, media-sensation glory.
 
"Do you trust Hillary?" friends now ask when we get together for dinner.
 
"So what do you think of Trump?" my colleague asked as we were wrapping up a conference call.
 
For a while, a part of me resisted talking about the election. The anger and divisiveness really bothered me. But the more I thought about it, the more I realized that keeping silent was a mistake.
 
Because we're healthcare providers, some people will inevitably ask us questions and put stock in our answers. And I believe our answers can really make a difference for both healthcare and our country.
 
High Stakes
 
No political system is perfect. But I truly believe America's is the best in the world. While it hasn't always been on the moral high ground, it's generally evolved toward greater freedom, opportunity, and human dignity. This has allowed us to grow into an incredibly diverse nation, one with potentially enormous reserves of ingenuity, openness, and cultural riches.
 
But somewhere in the last few decades, our elected officials fell out of step with their constituents. Polls show Americans have largely lost confidence in all branches of the federal government. And while the fractured Republican Party is the most obvious casualty, this disaffection cuts across party lines.
 
These frustrations are coming to a head in a year when the stakes for healthcare couldn't be higher. There's a real push to repeal, dismantle, or scale back healthcare reform — a movement in which hospitals, providers, and governments have already invested an unprecedented amount of money. Candidates' televised sound bites fail to convey the incredible complexity involved in creating a fairer, safer, more sustainable system.
 
The Supreme Court, which twice upheld the ACA, also faces an uncertain future. It's anyone's guess whether President Obama will succeed in filling the vacancy left by Justice Scalia's recent death. Three other justices are expected to retire within the next few years. With constitutional challenges to the ACA still pending, the court's composition could have a huge impact on the final shape of healthcare reform.
 
And it's not just healthcare that's at stake. It's our unity as a people. Sure, there have always been divisions among races, religions, sexes, and the haves and have-nots. But the rhetoric, vitriol, and sensationalism generated by the candidates (and fueled by the media) are likely planting new doubts.
 
At a time when our country faces many challenges, no one is encouraging us to embrace our similarities and unite on the same team.
 
Tips for Positive Dialogue
 
If we're no longer looking to politicians for guidance, maybe it's time to look to one another. When others seek out our opinions, we have an opportunity to diffuse the rhetoric and refocus them on what really matters.
 
Some tips for constructive dialog during election season:
 
  • Get informed. As we healthcare types are painfully aware, election coverage tends to focus on personalities rather than substance. (We know Donald Trump wants to "win again," but when did you last see a really insightful explanation of hospital quality on the local news?) If you want to be a force for good, start by learning what you can about the issues of the day and how the major candidates plan to address them.
  • Agree to disagree. It's like the old saying goes. If two people agree, there's no use for one of them. When you model respect and tolerance for the views of others — no matter how opposed they might be to yours — respect tends to come back to you. And you'll have the opportunity to keep the conversation going.
  • Shift the conversation from personalities to issues. When someone asks what you think of, say, Bernie Sanders, answer in terms of issues. Chances are, you agree with Bernie (or any candidate) on some matters and disagree on others. And be sure to ask for the other person's opinion. You may find that despite differing politics, your core values are pretty similar.
  • Emphasize the process. I'm always surprised by the number of people who feel demoralized about democracy because they don't believe that their vote "really counts." Do our Electoral College and delegate systems have some quirks? Sure. Should we tolerate voting scandals? Definitely not. But when you really look at the nuts and bolts, it's incredibly difficult for any candidate to outright "steal" an election 
  • Which brings us to engagement. It's especially difficult to "steal" an election when an enthusiastic electorate turns out in large numbers. Encourage people of all political views to do their homework, get involved, and involve others. Participation strengthens the integrity of our political system.

You can do all of the above without saying a word about your personal views. And if you do a good job, the other person might walk away from the conversation with no idea who you support.
 
Your Secret Weapon
 
Perhaps our strongest value as healthcare providers is our sense of compassion. And it's a perfect foil to the vitriol and divisiveness that's risen to the surface of this election.
 
When a would-be assassin shot Ronald Reagan in the chest in 1981, the president was rushed to the trauma center at George Washington University Hospital in heavily Democratic Washington, D.C.
 
Reagan's condition was critical, but still able to speak in the operating room. "I hope you're all Republicans," he said to the team.
 
"Today Sir, we are," replied the surgeon (who was in fact a liberal Democrat).
 
I think that story underscores our values as healthcare providers. We don't care who our patients vote for, where they were born, whether they're citizens, or whether they're rich or poor. When they need us, we put aside our personal affiliations to get the job done.
 
So as you navigate this election cycle, realize the burden you wear as a physician, administrator, PA, NP, nurse, technician, scribe, or anyone who works in the industry. And wear it proudly. Through your positive interactions with others, you can help to mend bridges, soothe anger, and show people that at the end of the day, we're really all on the same team.
 


Comments
David Birdsall
Nice article Jon.
5/30/2016 3:01:19 PM

Stephanie Jones
Thanks for sharing Jon. Excellent thoughts and challenges.
5/26/2016 8:30:35 AM

Shaun Partlow
Well said, Jon! This is a very tough election cycle, but really the polarizing of politics (and then society) has been going on for decades. It seems to be "win at all costs" without regard for what is best for the nation - for the people of this great country. You remind us that we can have any kind of political opinion but still be looking out for people. Specifically, for the patient in front of us, and for all patients. Everyone, after all, is, was or will be a patient at some point. Wish our politicians could keep that in mind.
5/23/2016 6:30:56 PM

Kevin Riggs
Excellent job Jon! Really enjoyed your insight.
5/20/2016 7:37:52 PM

Cyndy Flores
Nice take on a difficult subject!
5/20/2016 10:29:03 AM

Dr. Carl Stilson
Jon - fabulous article ........ We do live in a great country .....
5/20/2016 10:12:54 AM

True McMahan
I hope the PA-C's and NP-C's out there are all aware that our approval rating is THEIR approval ratings because oftentimes we are one and the same on the chart and in our patients' eyes. They literally prop us up and keep our engines running. As the song goes, "you are the wind beneath our wings...."
5/20/2016 9:50:01 AM