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Why Clinicians Should Get More Involved in Public Health

By IHI Open School | Wednesday, June 10, 2015

Jonathan Brach is an EMT in Woburn, MA, and an aspiring medical student. He participated in the new IHI Open School course, Leadership & Organizing to Improve Population Health, a 12-week field-based course that’s part of the IHI Open School Change Agent Network, or I-CAN. Below, he tells the story of how he confronted a major public health problem — texting and drivingwhich is illegal in Massachusetts and many other states. (Learn more about population health in our course, TA 101: Introduction to Population Health.)

As an EMT, I spend a lot of time on the roads driving an ambulance. While I see people doing a variety of unsafe things throughout the day, there are few things that annoy me more than seeing another driver looking at his or her cell phone instead of the road.

The reality is that texting and driving cannot be done safely, no matter what the circumstances. The Virginia Tech Transportation Institute released a study in 2009 that showed that drivers are 23 times more likely to crash while texting and driving than when driving without distraction. Thirty-nine states have passed laws forbidding texting and driving. But somehow, texting and driving is still a very common practice on roads across the country.

Planning a project

So when I started planning a community-based project to do for the I-CAN course Leadership & Organizing to Improve Population Health, I decided that I wanted to devote my time and energy to making sure that the people in my community do not text and drive. The I-CAN faculty encouraged us to do more than raise awareness with our projects, and to actually enlist people to take action, so I decided to make a goal of encouraging 1,000 people to pledge not to text and drive, and encourage their family and friends to do the same.

As it turned out, obtaining 1,000 signatures in a little over a month proved to be more difficult than I anticipated. Based on my experience collecting signatures for Dr. Don Berwick’s campaign for Governor of Massachusetts, I decided to engage people in conversation outside of supermarkets and ask them to pledge not to text and drive. But the majority of people who I tried to engage with the simple question, “Do you have a minute to help me with a public health project?” either gave me a flat-out “no” or walked by me like I didn’t exist. And to make matters worse, I had a lot of trouble recruiting my team members to stand outside of supermarkets with me. My family and closest friends just don’t have as much fun engaging strangers in conversation as I do.

Shifting strategies

It was at this point that I realized if I wanted to have a successful project, I had to adjust my strategy to the challenging circumstances I faced. I never was able to get the majority of people who walked by to talk to me, but I did do my best to convince those who did stop and talk with me that texting and driving was a really bad idea. In addition, I asked my family and friends to collect pledges in the way that worked best for them. For my parents, that meant bringing pledge sheets to work to have their colleagues sign. My brother Joe asked all of his high school friends to pledge not to text and drive. And my friends posted Facebook statuses in support of my project and sent an online version of the pledge to everyone they knew.    

As of May 22, my team has successfully collected 544 pledges! Two pledges of note come from the chief financial officer of the Institute for Healthcare Improvement and a local state representative, both of whom were nice enough to stop and talk to me outside of the supermarket. While we did fall short of our ambitious 1,000 pledge target, my team is nonetheless pleased with the results.

Lessons learned

I think the biggest lesson I learned from the I-CAN course is how to put a distributed leadership model into action. While we usually think of a team as one leader with several passive followers, the reality is that teams are much more effective when everyone takes ownership of the team’s goals and brings their own creative ideas to the table.

In addition, I-CAN has made me a strong believer that all clinicians should get more involved with tackling public health problems like texting and driving. The challenges we face in population health today are too important for health care providers to remain within the confines of the clinic. By choosing to step outside of their comfort zones and confront the causes of unhealthy behaviors in their communities, clinicians will not only help improve the lives of their neighbors, but they will also undoubtedly receive a boost in their own personal satisfaction in their work.

And you can still pledge not to text and drive here!

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