The Future of Healthcare Delivery Research

Below is my monthly message for the February 2021 edition of the MHRI newsletter, Focus. You can view Focus online at MedStarResearch.org/FOCUS.

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“The ability to ask questions is the greatest resource in learning the truth” Carl Jung 

Dear Friends and Colleagues,

Early in my career, I was at a large national conference as my friend presented an exciting new, cutting edge technology. I was so happy that his hard work had come to fruition and he could show the entire medical community the benefits of this novel technique. Given my excitement about his work, you can only imagine my surprise when the cardiologist sitting next to me said “that will never work!” 

“What!! What do you mean? The data clearly demonstrates that this technology works,” I respond. His reply baffled me: “Look, you may have 20 minutes in your ivory tower medical center, but I live in the real world and I only have 2 minutes for this part of the exam.”  And he was right – 15 years later an international task force was formed to understand why this new technology was still un-adopted in routine clinical practice!

Science is the creation of knowledge. Modern medicine is filled with highly effective drugs and devices because of scientific breakthroughs. However, modern medicine is also plagued by very slow adoption of new technologies and large disparities of care. This is why the field of healthcare delivery research (or health services research) has emerged as vital in order to ensure the best and brightest aspects of medicine are available (and used) in all parts of our society. A wonderful discovery does no good if it is not getting to those who need it the most.

Today, in February 2021, I marvel at the science that created, tested, and delivered 2 highly effective COVID19 vaccines within one year of the virus’ arrival. Never has the power of science been so strongly exemplified. However, we are again learning the sobering lesson that science alone is not enough. 1 in 645 Black Americans has died of COVID-19 (as compared to 1 of 825 white Americans) but white Americans are being vaccinated 3 times as fast as Black Americans (according to data from the 23 states reporting).  We need to understand why this is the case. Is it access, concerns about side effects, underlying mistrust, or something else? The answers are likely multifactorial and vary from person to person. So, how do we approach such a complex situation to ensure every person can reap the benefits of the best scientifically sound, medical care available?

Adam Grant, Wharton professor and best-selling author, just published a book entitled Think Again: The Power of Knowing What you Don’t Know. In his book, he warns about our first instinct of preaching (“Let me tell you what is right”) or prosecuting (“You viewpoint is wrong”) because these approaches rarely open anyone’s mind. Instead, he suggests that we approach different opinions about a topic with curiosity and ask questions. The goal is to understand differing perspectives. It is only after fully understanding vaccination hesitancy that we can help provide the information, access, reassurance (or something else entirely) to ensure every person is fully informed to decide what is best for them and their family. While I believe in scientific data and eagerly received my vaccine, data shows that this is not true for everyone. Taking Grant’s approach, I am invested in listening and learning other perspectives, so we can support each other through this pandemic.

On this snowy day, take a moment to consider another perspective. Share your perspective and information openly. It is through understanding and sharing that we will continue to advance health for all parts of our community.

Stay well, stay warm, stay safe and wear your mask!

Neil 

Read Focus online at MedStarResearch.org/FOCUS.