No one law, no one policy, no one model, no matter how innovative or effective, can ever address all the things that need improvement in health care. But one thing is essential: an engaged and informed public. The first step to solving a problem is recognizing that there is a problem; the second step is understanding the problem.
At IHI, we’ve long appreciated the incredible power of stories. Stories — especially first-hand accounts from patients, family members, and care-givers — bring statistics and data to life, and can communicate the need for improvement in immediate and powerful ways. Stories help us understand.
Two new documentaries being released this fall do an extraordinary job of communicating many of the crucial issues, and potential solutions, in health care — and they do it by telling stories. I urge all of you to set aside time to watch them.
Money & Medicine, an hour-long film by Roger Weisberg, premiers on PBS on Tuesday, September 25, at 8pm ET (check local listings). It examines the ethical, medical, and financial challenges of reining in spiraling health costs. We’ve all heard the harrowing statistics: we spend $2.7 trillion on health care each year in the US, 75 percent of it on managing chronic diseases. And it’s getting worse fast. By exploring the wide variations in care (and costs) at the beginning of life, and at the end, Money & Medicine tells the story of a health care system that’s not serving the needs of patients and threatens national prosperity. It features commentary by some of the leading figures in the improvement community, including two of IHI’s current board members: Dr. Brent James and Dr. Elliott Fisher. One of the stories from Money & Medicine that resonated with me was of a son, dutifully caring for his ailing mother in an ICU. His commitment to his mother and faith in a possible miracle, despite a negative prognosis, remind us all how personal and emotionally charged these issues around end-of-life care can be.
Escape Fire: The Fight to Rescue American Healthcare is a feature-length documentary by Matthew Heineman and Susan Froemke. It premieres in select theaters across the country, on iTunes, and via Video on Demand on Friday, October 5. The title is probably familiar to a lot of you since it’s inspired by Don Berwick’s 1999 National Forum keynote in which he recounts the use of a radical approach to wildfire survival ---- setting your own smaller fire to prevent the larger fire from overwhelming and consuming you ---- and offers this “disruptive (even counterintuitive) innovation” as a metaphor for what’s needed in health care. Don appears in the film, along with journalist Shannon Brownlee, prevention advocate and wellness expert Dr. Andrew Weil, and a host of other innovative leaders in health care. The film closely follows the often heart-breaking challenges patients and clinicians face as they try to treat, and be treated, in a fragmented, costly, and often ineffective system. I was particularly struck by the account of a young primary care physician from Oregon, and her agonizing decision to leave a practice that was not meeting the needs of her patients, and not satisfying her professionally. The hope and renewed energy she found in pursuing a fellowship and practicing in a new model underline the power and promise of redesigned systems of care.
We all get frustrated by the slow pace of change in health care, and these two new films tell many stories that confirm that frustration. But they also offer hope. You can and will find hope in the dedication and determination from leaders, innovators, and front-line care givers who share our passion to improve.
We all have a responsibility in a democracy to inform ourselves and use that information to hold our leaders and representatives responsible. And as patients, we all have a responsibility to communicate what we want ---- what matters to us ---- to our care providers and to our loved ones. Documentary films like Money & Medicine and Escape Fire can help us accomplish both. The more we learn about the quality and cost saving changes possible, the more we can become informed actors at the local level.