The Public Conversations Project prevents and transforms conflicts driven by deep differences in identity, beliefs, or values.

Humanizing Health Care

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Again and again, we hear how “dehumanizing” the U.S. health care system is. And certainly the political system can be equally so, as seen in public discussion (debate? outrage?) in past months.

Some of us at Public Conversations are mental health professionals, a couple are doctors, but we don’t spend all our time in hospitals, or counseling centers, or schools of medicine, and we are not health care managers or policy analysts or advocates. What, then, do we offer to people who are?

We asked that question earlier this month, when we offered a free workshop called “Connecting & Collaborating Across Differences,” in partnership with the Division of Public Health Practice, Harvard School of Public Health. In honor of World Health Day (April 7), it was open to anyone in the field of health care, and participants included nurses, students, therapists, administrators, and EMT’s.

One answer came from a participant who appreciated learning about “helping people respectfully manage potentially horrendous problem-solving processes.”

And it’s true: our approach is an alternative to the practice of starting with whatever problem needs to be solved, and then lining up on different sides of the table to argue positions, benefits, costs. In dialogue, participants get rid of the table, put the issues in the corner, and find out more about the people in the room. What does each person wish others could understand about them? What does each person wish they could understand about the other? What really matters to them about health care? Dialogue involves responding to questions like these, listening and speaking in new ways, resisting any easy categorization of “us” and “them,” (whether it’s “providers vs. consumers” or “providers vs. administrators”), and being curious and interested in learning, instead of asserting what is certain, known, or true.

More broadly, dialogue is an opportunity to “rehumanize” people in systems like health care. Not just the people who are perceived to have power, and not just the disenfranchised, either. Dialogue invites all participants, equally, to share their experiences and explore the multiple and complex—even contradictory—perspectives. People are asked to speak as individuals, not on behalf of all people on their “side,” or in their role, or with their status.

This is not to deny real differences in power between, for example, providers and consumers of health care, or people in different racial or socioeconomic groups, but rather to suggest that systemic inequities might be addressed in new ways by shifting conversations and relationships. In dialogue, no one is expected to change their own or anyone else’s minds. But in the process of coming to know and trust one another, they discover what’s possible for them to talk about, and imagine, and do together. They might even be able to change the system.

Alison Streit Baron, Program Manager, Public Conversations Project
April 26, 2010

Check out this slideshow from the workshop.

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Productive Conversations in Healthcare

Submitted by Chris Holland (not verified) on May 5, 2010 - 12:16pm.

Very interesting project. Understanding before decision-making and action is most critical in healthcare. While there has been a significant investment in clinician / patient understanding, big gains can be made with more effective understanding between clinicians, clinicians and admin, senior management and middle and front line, ... Most challenging when a superstar physician assumes a Medical Director role ... the pressure and life-long expectation to be the expert needs to take a back seat to engaging competent professionals in collaborating to find the best solution. Not to pick on docs, the challenge exists throughout healthcare organizations. Investments in TQM, now Lean provide structures and tools for advancing collaboration however without sound dialogue infused in the process, the old solutions win out. Would love to understand your thinking about when and how dialogue can become part of fast-paced, day-to-day operations, and then on to effective decision-making and action. I've been exploring "productive conversations" in vivo, continually testing and learning, in some of the most heated situations. There may be such a thing as "Good enough dialogue." Gritty, sometimes heated / passionate exchange that accomplishes greater understanding of the other re the most critical issues, meeting of the minds to build on a core of agreement, shelving of un-resolveable non-critical arguments, and sufficient alliance to move forward productively. One small example - Story on BLOG: http://bit.ly/akSFe5 prices single panel met (methamphetamines) home urine test kit Theres a lot to be learned from your work and its implications for organizational interventions aimed at achieving clinical and business results in healthcare. single panel opiate (her, mor) home urine test kit prices