Hamstrung doctors. Disliked pharma companies. Number-crunching HMOs. Slick holistic healers. Understaffed government agencies. Caregiving families. Gatekeeping nurses. Skeptical journalists. Overwhelmed patients.
Health communicators are in the middle of it all. Our jobs have always have carried a degree of responsibility because the messages we convey literally can be matters of life and death. But today, as we near 2003, our job description has expanded from marketing supporter and reputation manager to facilitator and yes, healer, of the health sector. The health sector is making enormous progress in extending and improving the quality of life. Advances in biomedical science and technology give us benefits today, and the promise of even better ones tomorrow. So why don't we feel wonderful? To bring this innovation to the public over the coming years we need to understand the three E's confounding the health system: expenses, entitlement, and education. Expenses are going through the roof. The Centers for Medicare & Medicaid Services projects that national health expenditures will reach $2.8 trillion in 2011, and will constitute approximately 17% of the GDP, up from 13.2% in 2000. As healthcare costs increase - through the converging trends of an aging population, increasing numbers of patients, fewer working people, and expensive, advanced diagnostics and treatments - leaders and laypeople alike are experiencing high anxiety. There is a risk of focusing on quick-fix remedies that are not the long-term solutions we need. Entitlement to health and healthcare is the second E. This age-old sentiment prevails. We resent the health industry for profiting from our pain, suffering, and misery. Yet we depend on its continued innovation if we want our children - and their children - to reap the benefits of biomedical discovery. Education, the third E, is where we health communicators can - and should - step in. We need a sea change in public and institutional thinking about the health industry - a turnaround in attitude about what's broken (the system, not the science), who's responsible for fixing it (all of us), and how we will fix it. No structure or premise can be held as sacred, except the importance of retooling for optimal public and personal health. The educational curriculum that arms our leaders and our populace to make wise health choices, for their bodies and their world, cannot be achieved in a 30-second spot, in a closed-door conference, or through an array of leaflets in doctors' waiting rooms. We need education that is brilliant, magnetic, scintillating - think Sesame Street meets Jackson Hole meets the best professor you had in college meets The Karate Kid's Mr. Miagi. We need didactic education. An array of thinkers from inside and outside the health world must understand the nuance and work toward long-term, actionable solutions that will not force society to choose mediocrity in medicine or health. So what does CMEE (continuing medical education for everyone) look like? Health 101 is the clinical stuff. It includes body literacy, health promotion, disease prevention, family caregiving, self-care, patient skills, disease signs, and therapeutic approaches. Health 102, the health economics curriculum, covers the healthcare delivery chain, factors both explicit and occult that contribute to health costs, and investing in health. An adjunct to this curriculum is the rudiments of the discovery process and the brilliant investment that is preventive health. Once educated, people will be able to opine, gossip, vote, publish, or be advocates for the industry. Without this education, we as a society will turn off innovation and discovery, and we'll miss much in the near future. As communicators, we can and must be part of the solution. With health innovation at once tantalizingly close and out of reach, what is needed is partly in our power to provide. This may differ from the typical view of ourselves as supporting cast rather than on-stage performers. Perhaps the more accurate analogy today would be "stage managers," who don't wow the audience, but ensure that everyone knows their cues, that the stage is set, and scene changes are fluid. Back in 1984, when I was a rookie press representative, it was a thrill to be able to call my grandmother in Florida early one morning and tell her to tune into Good Morning America, where "my story" was going to be broadcast live from the neurosurgical suite at Mount Sinai. I was bemused when my grandma called later to ask, "Where were you? I didn't see you anywhere!" Of course I explained that the Mount Sinai brain surgeon was the star, and that I was simply the behind-the-scenes communications coordinator. Today, that's not necessarily so.
