Converting political fervor for the benefit of everyone

February 1, 2005

Politics are a very strange animal. The vehemence brought to the table by the extreme left and right, and just about everyone in between, strikes me as both frightening and encouraging.

Politics are a very strange animal. The vehemence brought to the table by the extreme left and right-and just about everyone in between, too-strikes me as both frightening and encouraging.

One on hand, the activism is heartening to see, especially in the youth. More people cast a ballot in 2004 than in any other Presidential election in the nation's history, accounting for nearly 60% of eligible voters.

On the other hand, I read recently that while all of the ballots haven't been counted yet, 50% or more of the eligible population voted in Iraq's first election-and every single vote they cast was its own small victory.

I vote, but readily admit I wouldn't have the courage to vote if I had to do it under the pall of a death threat. Then again, if improvements aren't made in the U.S. healthcare system, preventable errors will kill thousands of Americans as surely as any act of violence.

Dr. Don Berwick, CEO of the Cambridge, Mass.-based Institute for Healthcare Improvement (IHI), is trying to tap some political strategies to create a groundswell of support for making desperately needed changes. The subject of this month's Executive Profile, he has seen the healthcare system in action from almost every perspective-practicing physician, academic, activist and businessman-and he's tired of strategies without deadlines.

"I'm losing my patience, not with the people in healthcare, but the system itself," he said during his keynote address at IHI's recent annual meeting in Orlando. He wants results, not promises of vague improvements to be achieved by some unspecified date. Borrowing a motto from the political arena, he often says, "Some is not a number; soon is not a time."

THE SAFETY IS IN THE DETAILS Dr. Berwick wants to save 100,000 lives by 9 a.m., June 14, 2006, and he has identified six specific changes that will achieve that goal. When he outlined his plan to me, with all of its details and very specific timelines, it was a genuinely moving experience. Looking at the ideas and deadlines in black and white made me believe. In fact, his figures are admittedly conservative, assuming that only a third of U.S. hospitals will implement the changes, and that they will achieve a smaller success rate than established studies have shown to be possible.

This past year, I watched in fascination and horror as intelligent people on both sides of the political spectrum spewed vitriol at each other over a pseudo-documentary by filmmaker Michael Moore. You could see the rage and aggression in their eyes, and in some cases, it looked like barely controlled violence.

I understand the intensity to a certain extent-it was a polarizing film, for certain-but where is that energy when it comes to our healthcare system? Someone, somewhere, probably suffered an adverse health event while they were actually watching that film and had to go to the hospital. Did the concern and apprehension they felt while watching the movie escalate as they were en route to a healthcare facility? If not, perhaps it should have; experts agree that hospitals aren't as safe as they could and should be.

My guess is, though, that their moral and political dander cooled after they left the theater, and that's the first thing we should strive to change.

We need, as Dr. Berwick is showing, to harness that activism and motivation to change healthcare-not for some of us, but all of us-and we don't need to do it soon, we need to do it today.