Patient Advocacy on the Cusp of the Tipping Point

A tipping point: a dictionary definition will tell you that it means “the crisis stage in a process, when significant change takes place.”

And for patient and health advocacy – we are almost there. Almost at the tipping point.

I first learned the term when I read Malcolm Gladwell’s book by that title, The Tipping Point. I learned that the term is borrowed from epidemiology. That is, when a contagious organism infects enough people to go from just a few sick people, to hundreds, or thousands or millions – the tipping point occurs in that modicum of space or time, when all of a sudden it switches from almost epidemic to being an epidemic. It’s when that threshold is crossed.

Another way of looking at it comes from Hollywood – when an “overnight success” is recognized, even though he or she has been acting, singing or performing for many years prior to that point. But that point between when few know who s/he is and millions recognize his/her name – that’s the tipping point.

Tipping points don’t happen by themselves. They require a set of circumstances that make the tip happen. Gladwell describes types of people who make them happen: connectors, mavens and salesmen, all of whom have a role in helping a concept cross that threshold to become mainstream.

In the past week, two people have shared links that indicate to me that we are almost there. Both are quotations from well-known or well-regarded people who have identified or described what patient advocates are doing, thereby moving us closer to the mainstream. These aren’t people who are involved in patient advocacy, meaning these quotations are in no way self-serving. They are observational – and powerful.

The first quotation comes from Dr. David Lawrence, the retired CEO of Kaiser Health System. The crisis he identifies is the total dysfunction of the American health care system, and he states that he believes it will be entrepreneurs, not the government, who will fix the system. Among the entrepreneurial ideas he focuses on are two advocacy services:

Triage, or helping consumers determine whether they need to seek medical attention in the first place. … We know that people, when given the right information in a timely fashion, will make different decisions about when they need to interact with the medical care system.

Navigation: Directing patients to the right caregivers. Patients “ping pong” throughout the system, with little to no appreciation of which doctors and hospitals provide the best value and will add value rather than contradict. Any company that can fix that has promise.

Of course, Lawrence uses “navigation” to describe advocacy – not to be confused with the current system of cancer navigators who work directly for hospitals, and don’t actually help patients search out new doctors or prevent them from pingponging. (Thanks to Dianne Savastano, Health Assist, for sharing this piece from Dr. Lawrence.)

The second quotation comes from the biography of Steve Jobs. A quote from the chapter in the book focused on Steve Jobs getting sick for the third (and unfortunately final) time.

The following Saturday afternoon, Jobs allowed his wife to convene a meeting of the doctors. He realized that he was facing the type of problem that he never permitted at Apple. His treatment was fragmented rather than integrated. Each of the myriad maladies was being treated by different specialists – oncologists, pain specialists, nutritionists, hepatologists, and hematologists¬† – but they were not being coordinated in a cohesive approach. One of the big issues in the health care industry is the lack of caseworkers or advocates that are the quarterback of each team, [Laurene] Powell [Jobs’ wife] said.

This one needs no further explanation. It’s what we do. But it seems apparent that no one did it for Steve Jobs. (Thanks to Alan Blaustein for sharing.)

Those of us involved in private patient advocacy today, we who are creating the tipping point, will watch that threshold be crossed from little-known to mainstream very soon. We are the pioneers – and when that transformation takes place, we will be the “overnight successes.”

It’s exciting, it’s a bit daunting, and we need to brace ourselves. It’s going to be a little like putting out a birthday candle with a fire hose.

We need to be prepared. Are you?


3 thoughts on “Patient Advocacy on the Cusp of the Tipping Point”

  1. Pingback: What is a Patient Advocate? | The Valley Health Report

  2. This is a wonderful piece Trisha. I loved the book “The Tipping Point” and I completely agree that patient advocacy will reach a tipping point. So how soon is “soon”? When do you think this might happen? 10 or 20 years? Or even sooner than that?

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