When I boarded my plane to visit DC for the Telluride Conference, I expected to be bombarded with political ideas about healthcare reform. After all, healthcare reform is a heavily politicized topic in the national conversation, and both sides claiming that their political beliefs are best for promoting the health and safety of the general populace. As I reflect back on the past two days, however, I have come to realize that healthcare reform and patient safety do not need to be political discussions; and in fact, should be a bipartisan endeavor that focuses on understanding and implementing changes based on psychology rather than on politics. In my blog posts, I hope to explore a few of the key psychological issues that could have a positive impact on patients.
A large issue facing our healthcare system is that the culture is incredibly hierarchical, and the hierarchy seems to punish challenge. We learned, for example, about several cases in which wrong sided surgeries were performed in which the nurses or anesthesiologists knew that the wrong side was being operated on but were too afraid to let the surgeon know. We also learned about cases in which patients were afraid to ask surgeons and physicians questions because culture seems to expect doctors to receive deference as authority figures. Effective change will require a reworking of the relationship between different healthcare providers so that relationships are seen as partnerships rather than authoritarian. Similarly, patients need to be seen as partners in their own health instead of being seen as ignorant and knowledgeable.