The women’s health movement in the seventies focused a lot on empowerment and respect—giving women the information and resources they needed to make good health decisions, in a supportive environment. Which is what anyone deserves of course. It is what inspired me to go into medicine, but I was not alone; the larger community health movement evolved to address many local needs in “underserved” populations due to poverty, gender, color, language, or immigration status. They still carry this torch, and those who staff these clinics are some of the most dedicated and community-oriented people you can meet.
Are people merely “consumers” seeking to get the best deal from health “providers” based on market factors (and their satisfaction is important so they will keep being customers?) Or are they just people needing to heal?
Keeping “the mission” of service and empowerment is not easy of course. Good intentions are not enough—you also need skills, training and support. Growing into a large organization struggling to survive financially can lead to missteps. Disrespecting the staff will poison their ability to provide service. There are myriad pitfalls.
I experienced many of the stresses working in both frontline care and as administrator. Those of us interacting with patients daily were driven to take time to listen, discuss, problem solve, comfort, document and create relationships. Those minding the books were driven to get more “productivity”, going so far as to accuse those seeing patients of doing “too good a job”. To be fair, everyone shared a desire to provide health care and keep the doors open, but finding a balance was hard. And harder since we were trying to create another model within a larger health environment that didn’t share our passions.
The tension between trying to heal people and to run a business may be inevitable in any health system but it is worth asking whether the primary mission is to improve health of people or of pocketbooks. Are people merely “consumers” seeking to get the best deal from health “providers” based on market factors (and their satisfaction is important so they will keep being customers?) Or are they just people needing to heal?
My position is that healing comes from taking care of each other, not taking advantage. Health does not simply emerge when treated as another business transaction between customer and purveyor–as a critique of the US system can attest. And as It turns out, having growth and profit as the primary goal is not a healthy paradigm for planetary survival either. There are many opportunities for change. I believe that if we see our most important mission as one of mutual service, empowerment and respect, then we have the best chance for the future.