The eleventh Salus Health Care Forum was convened on April 2, 2025. In attendance were William Bergquist, Jerome Fish, Bill Gillanders, Gay Teurman, Mark Vukalcic, and Jack Westfall. The Trigger topic for this forum was provided by Bill Gillanders, who offered the challenging proposition that narratives might be the most effective ways in which to influence broad-based attitudes regarding health care in the United States, and, more specifically, the benefits of family medicine in the treatment of patients during this troubled time in American history.

Following is a narrative based on the dialogue that was engaged at this Salus forum:

Jeremy

Our trigger topic for today is provided by Bill Glanders. Bill is going to share with us some of his thoughts on narratives, I think the function served by narratives in leadership is key. Maybe some current events suggest that the background of narratives used in science have not been able to reverberate in the public domain in ways that other narratives have. Bill, do you want to go ahead and initiate your trigger topic for today?

Bill G

I titled it “Curating an Effective Narrative with Selective Use of Alternative Facts.” When we first started this set of forums, one of the questions was, how do you actually establish an effective narrative that actually causes things to change? We have such a powerful fact-based narrative about how broken the healthcare system is. Yet, that narrative doesn’t seem to have gained traction over our careers in terms of fundamental change of the organization of US healthcare. Then it struck me that this last election, and I’m not referring to what the president’s rolling out today, but the success of his 2024 campaign was really based on this idea that he was able to sell the narrative of America in decline, and the catchphrase of Make America Great Again. That proved to be a very powerful narrative in terms of getting people to vote for him.

At first, I went back and said, well, what is the evidence? Is this an evidence-based narrative? It actually turns out that the America in decline has a pretty broad intellectual base that dates back at least to the 1950s, I think we’re all old enough to remember Jimmy Carter’s very preachy America in decline speech, and then Ronald Reagan’s morning in America comeback that was very important in his campaign in the 80s. With that, I really appreciate what Bill B has written about the life of facts, and the objectivism versus the constructionism of ways of curating an effective narrative. Maybe Bill, you want to talk a little bit about how narratives are created.