I’d make a way better bluegill than politician. If you’re an advocate for safety net providers, I’ll bet you’re the same way. We tend to be thin skinned and take the bait way too easily.
Facebook has become my new battleground. Maybe it’s just that I’m getting more cantankerous as the years add up, or maybe its because with the instant access to interactive dialogue, we’re just much more exposed to total B.S. and its finally ground me down. It’s kind of like SpongeBob. If you’re a parent of a kid born anytime after 1995, you know where I’m going with this. SpongeBob seems to be on television at all times. He doesn’t bother me in small bits, but when he’s blaring the background for three, four hours at a time with that nerve tweaking laugh, you finally snap. The same is true for what seems to be the constant drip of B.S. on Facebook. You know the posts – they usually end with “re-post if you agree.” I almost never agree, and I certainly don’t re-post; in fact, I’ve taken to simply responding.
I recently engaged in, um, dialogue, with several people I’ve never met. One exchange was in response to a post about “Obamacare” that cited a number of remarkably ridiculous statistics about American healthcare. Any of us that is involved in primary care, mental health care, and community health in any function would look at those numbers and recognize them for total fabrication. I try (TRY) to stay out of political debates, but this one was so full of outright lies and nonsense that I felt it was doing harm on the important national discourse we should be having on such a vital topic. So I challenged it (Probably much the same way that Dirty Harry challenged the punk in his “do you feel lucky?” scene). I got suckered into another debate on a popular post being battered around about states’ policies on another topic. I’m being vague because there seems to be enormous emotion tied to this particular one, and I don’t want to get sidetracked into the debate itself, but rather to point out the symptom of a bad debate platform: no data to support the claim or position.
In grad school I had a Stats professor who taught us to tell a story using data, and to build a presentation using no more than three Powerpoint slides to illustrate it. Cut out the emotion and drawn out explanations and let the data tell the story.
This lesson is so inherently true as we advocate for primary behavioral integrated healthcare. The data is beginning to pour in as to the effectiveness and efficiency of the practice – when done correctly. We recently worked with a physician who was completely on board with the concept of integrated care. He loved the idea of the model, the clinical outcomes that it would produce, but he said it was killing him financially. Upon further study of the implementation, we found that the behaviorist he utilized was practicing a traditional mental health approach in the primary care setting; i.e. exhaustive assessment and intake processes, one hour sessions, treatment plan reviews, etc. “My exam rooms get all tied up, patients get frustrated and leave, she only sees a few patients a day,” he said. “It’s killing my practice.” By having an appreciation of the data (patient cycle time, number of patients seen, access time, financial impact), the doctor was able to diagnose his practice’s illness and consult with us for a course of correction.
Much of what is started in community health is launched through the PDSA cycle – Plan, Do, Study, Act. We covered a bit of it in our last blog, but it’s such a vital habit to gain that it bears further discussion, particularly the “study” portion. Collect data, measure it, slice it, dice it, stretch it, give it to someone else to look at, and then use it to make decisions.
A recent post on the No Health without Mental Health website lists a number of positive outcomes and associated studies to corroborate the claims as related to integrated health. The Center for Integrated Health Solutions, a partnership of SAMHSA and HRSA and the National Council for Community Behavioral Health (disclosure: Cherokee Health Systems is also a technical advisory participant in the program) is about two years into a massive grant program that is producing remarkable data on the impact of primary care and behavioral health collaboration in mental health settings. The theory that integrated care works is a well traveled road paved with sound data headed toward actual reform.
Data is our friend. It is our tool to build something terrific, and it is also our sword when battling stigma and ignorance. Part of our duties of keeping the seams of our safety net tightly sewn is to confront misinformation and use the experience as a teaching tool. You’re probably much better at that piece than I. Someone once tried to educate me on the method of being a kind and gentle teacher. Maybe someday I’ll get there.
Shut up SpongeBob!