by Ted Wachtel
Giving people more voice is not just a matter of social justice or political correctness. It’s a good practice because everything works better when you do it.
The fundamental premise of the Building A New Reality Foundation (BANR) is that people are happier, more productive and cooperative, and more likely to make positive changes in behavior, when those in positions of authority do things with people rather than to them or for them.
So far, my colleagues and I have demonstrated the value of giving more voice to all stakeholders, especially in schools, youth service programs and criminal justice settings. But care professionals, including doctors at the top of the health care professional hierarchy, have not shown much interest. Therefore, I was delighted to read an article in my wife’s Moravian College alumni magazine, about Dr. Janine Jagger, an epidemiologist who has consciously opened herself to listening to patients.
She admitted that she did not initially value input from patients. “I was a researcher on the medical side. Patients were subjects, researchers were the professionals. That was how I saw things.”
Jagger had grown up in the traditional reality, believing that experts and professionals and leaders know best, and have little to learn from the large groups of ordinary people whom they serve. That old view is now being challenged by a new reality.
The Wisdom of Crowds was the name of James Surowiecki’s award-winning “best business book” of 2004. The Wisdom of Crowds deliberately contradicted the title of a classic 1841 book on crowd psychology called Extraordinary Popular Delusions and the Madness of Crowds. Surowiecki’s book’s subtitle offers to tell “Why the Many Are Smarter Than the Few and How Collective Wisdom Shapes Business, Economies, Societies and Nations.”
Jagger claims that she changed her view with just one exposure to an online patient conversation group. She said that patients were discussing treatment topics that were unknown to the medical community, but which had important implications for treatment. For example, patients reported that they responded differently to different brands of a particular drug. Jagger discovered that the response is “very brand-specific,” so that switching to another brand improved the odds of the treatment working.
Jagger realized that patient groups were “an untapped well of significant clinical insights.“ She saw herself “playing a unique role in bringing together the patient population as a research entity in its own right.” To accomplish that, she established a foundation to support research, and engaged the patient community as a primary source of discovery for therapeutic and quality-of-life strategies.
Power to the patients.
What we have learned is that wisdom is widely distributed among all human beings. To be fair, so is foolishness. The challenge is to establish participatory decision-making processes that tap into the best that we have to offer each other, and to filter out the worst. The Family Group Conference or FGC is such a decision-making process.
It originated in 1989 in New Zealand, and has spread to the United States, Europe and beyond.
In cases of child abuse and youth delinquency, when the government is considering removing a child from home, the process brings family members together to develop their own plan as an alternative. Research shows that families make better plans than experts, in part because family members are more invested in the plans they develop than those imposed by government social workers.
Like doctors, social workers have traditionally made decisions without much client input, but the FGC engages their clients directly in decision-making. Research in a large family group conference program in the Netherlands demonstrated that decisions by families in FGCs cost the government about half as much as cases managed by the experts.
Power to the families.
Giving people more voice not only feels right, but it produces better outcomes.