This forum held on June 5, 2024, was attended by three members of the Salus Forum: Jeremy Fish, Perry Pugno and William Bergquist. The June forum focused on strategies that can be engaged in the promotion of improved health care delivery. It benefited from experiences and insights offered by guest participant, Peter Sterling (a noted neurobiologist and author).

Following are some of the comments and observations made by participants in the June forum:

Trigger Topic: Strategies for Change

Four fundamental strategies for change (a coherent set of assumptions about effective change) have been identified based on findings from a project conducted by Ronald Havelock and his colleagues at the University of Michigan’s Center for Research on the Utilization of Scientific Knowledge. One set of strategies, called Rational Planning, concentrates mainly on developing a persuasive message based on evidence. Another set, called Social Interaction or Communication of Innovations, emphasizes the process and factors by which the change message gains the attention and acceptance of several different groups. It focuses on the social act of providing several different types of convincing messages. A third strategy, called Problem-Solver by Havelock, focuses upon how the receiver comes to feel the need and then the willingness to change. This strategy is based on behavioral science findings regarding how to address fundamental (often irrational) human concerns. The fourth, Political, strategy dwells on ways in which to generate change through advocacy and the creation of committed and passionate constituencies that will pass appropriate legislation and the allocation of sufficient resources.

Jeremy

Primary health care and family medicine was aligned from its birth with the social movements (civil right) associated with serving the underserved. It was engaged in a quasi-political strategy for change. Yet, our primary strategy has been rational. We are trying to convince people that preventative medicine is the way to go. We provide data, research results that prove our point. Yet, not many changes in attitude or priorities (resource distribution) have taken place. In the US 5% of resources are devoted to primary care. Up to 15% are devoted to primary care in many other countries.

We are conflicted. On the one hand, we are oriented to the social movement perspective – serving the underserved. On the other hand, we must get funding—the business side of our business. We look to serve in corporate leadership roles.