Perry adds another reframing strategy to what Bill B offered. Perry suggested that change might require a dramatic “in-your-face” statement. A patient who has been resistant to changing their unhealthy behavior asks what he should do next (other than change his behavior. The doctor responds: “You should start getting your affairs in order for you are going to die soon.” Is this too strong a challenge or is this what is often needed?

Bill B. noted that the threshold between traumatizing challenge on the one hand and stifling support on the other hand might be required. It is in this threshold that “flow” exists. Csikszentmihalyi believes that a “flow” experience is one of the most motivating states to which human beings gravitate. A rock climber, for instance, finds Flow when scaling a rock face that is slightly more challenging than the rock climber has faced in the past but is within the skill range of the climber.

Similarly, flow might play an important role in health care. A physician would find “flow” when dealing with a patient who poses a treatment challenge that is great (certainly not routine) but manageable (given the physicians training and past experiences). It is in the midst of Flow that time flies away (“has that really been an hour?’) and intense focus is sustained (“there is nothing else in the world right now!”). Patients also find flow when facing a health challenge that is great but still manageable. Bill B noted that he recently was treated (via radiation) for prostate cancer. At the end of the treatment program, Bill rang the bell and felt a moment of bliss (flow).

Jeremy brings this Health Care Forum to a close by once again identifying some overarching themes. First, several ways were considered that might help reduce the polarization to be found in health care (and in most other domains of contemporary life). Health care practitioners and those formulating health care policy can move to a new model of both/and. A positive reframe of health care challenges might be appropriate.  The villains identified during the forum were pharma and agri-business, as well as the profit motive that is prevalent in the private health care sector.

Bill B. offered his own concluding remarks. We can’t be naïve. We must listen to and take seriously what Jeff noted. Practitioners and policy formulators seeking to promote prevention and healthy behavior are losing ground. Evidence isn’t doing the trick.  Perhaps, we can learn from the success of Peter Attia (as suggested by Jeremy). Diverse perspectives and strategies regarding the introduction and maintenance of change must be identified and engaged. The rich perspectives and insights offered in this session of the forum can be helpful in this regard.

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References

Attia, Peter (with Bill Gifford) (2023) Outlive: The Science and Art of Longevity.  New York: Penguin/Random House.

Csikszentmihalyi, Mihalyi (1990), Flow. New York: HarperCollins.

Michael, Donald (1973) On Learning to Plan and Planning to Learn. San Francisco: Jossey-Bass.