Transparent Possibilities

Transparent Possibilities

By: Justin Vandergrift

Last month I had the opportunity to speak in Sweden regarding learning healthcare networks/registries from a parent’s perspective.  Registry use is widespread in Sweden; in fact there are over 75 registries.  Compared to the United States this is remarkable, even more remarkable considering Sweden has a population of 9.5 million people, 97% less than the United States.

Reflecting back, the greatest insight of the trip happened during the last talk I gave.  It was a very simple question that opened up remarkable personal reflection on the way home.  The question represents the benefits of both the Swedish and American healthcare systems and ultimately the problems with the American system.

The question presented was – ‘Can you change doctors?’  It never dawned on me that you couldn’t change doctors.  Americans have the ability to change doctors, or virtually anything for that matter, often very quickly and easily.  Although the American system does have its burdens, one of the benefits is the ability to choose how and where we are treated.

Swedes do not have that luxury.  They pay tax and are treated in the county they reside in.  If you live in Ostergotland and treatment is better in Sodermanland (both counties in Sweden) it does not matter.  You will be treated where you live.  The lack of choice creates a system where the patient has a vested interest in providing their physician the best possible information.  If you cannot change your physician, then would do anything possible to help your doctor.  This includes active participation in a registry.

In the United States that is not the case.  We do not have an interest in helping our physician or even participating in a registry.  Americans are keen to find the best physician and care (or anything for that matter) at all cost.  How many patients do you know who have changed doctors simple because one physician would not give them a specific medication?  Why partner with your clinic when you can fire your physician and find another one – often within the same day.

Changing the American mind is what is needed to save our healthcare system.  Everything in America is disposable, even your physician.  My hotel in Sweden was in a building hundreds of years old while around me at home there are 20 year old residences being demolished to make room for the latest mini-mansion.  Americans are taught to be brand loyal from an early age.  Many of us are loyal to a specific car manufacturer, sports team or clothing label.  Why?  There is a perceived benefit for doing so.  For most patients, there are no perceived benefits for registry participation.  There is no brand recognition for registries.

How to change the mindset?

The most immediate method is showing the benefits of the registry at patient appointments.  I am involved in the registry my daughter participates in, ImproveCareNow.  However I never see the benefits of her participation at clinic visits.  Her participation would be meaningless if I did not know what was going on behind the scenes.

ImproveCareNow uses a pre-visit planning process to help the clinic prepare for her appointment.  There are tools from the network being used by the physician that very few patients even know about.  ImproveCareNow should develop a worksheet given to the patient and family at each visit.  Allow the family to see their child’s data compared to a representative sample in the database.  Let the patient see the benefits of participating in the database at each visit.  We need to ‘brand participation’ and benefits for each patient.

We cannot continue to ask patients to embrace learning healthcare networks on faith alone.  We cannot continue to ask patients to sign consent and let the clinic do the rest.  Allow the patient to see the benefits of registry participation and you will begin to see a change and embrace of participation.

Imagine the passion we can create in patients by being more transparent.


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