In Search of ‘Goldilocks’ Health Care
Bill Doherty and Bill Adams are members of Baby Boomers for Balanced Health Care, a passionate group of baby boomers who are challenging America’s “more is better” mentality in an effort to reduce health care waste.
Doherty, a University of Minnesota professor, therapist and community organizer, said he got the idea for the group after attending a conference on health care change a few years ago.
“All of the conversations were about changing the delivery systems and payment systems,” he said. “I figured if we don’t engage everyday people about a more balanced use of resources, we are going to have a challenge.”
Doherty then convened people to discuss overuse and approached citizen leagues, patient advisory boards and the Institute for Clinical Systems Improvement (ICSI), a Choosing Wisely® grantee. The ICSI contact led him to Adams, whose years in public policy became personal when he had a heart attack. Adams joined the ICSI Patient Advisory Council, brought his patient voice to an array of ICSI projects that eventually became part of Baby Boomers for Balanced Health Care.
The group, which formed the same year Choosing Wisely launched, recognized that the campaign fit with its mission.
“The shift from ‘more is better’ has to occur at the physician and patient level simultaneously,” Doherty said. “But ‘medical overuse’ is not a catchy phrase. Our intervention is to develop some everyday language to introduce the concept of overuse and generate community conversations.”
The Baby Boomers group uses phrases like “overdosing on health care” to talk about the financial consequences and patient risks associated with overuse. Members use the phrase “Goldilocks care” to suggest that there is a “just-right” amount of care, somewhere between undertreatment and overtreatment.
The language is a catalyst for the conversation processes the Baby Boomers group developed—one for larger forums and one for small group discussion. As a Consumer Reports partner, Baby Boomers For Balanced Health Care shared its tools—which include Choosing Wisely handouts, conversation starters, facilitator guides and audio and video resources—online and with other Consumer Reports partners.
The small-group conversations are designed to be about 90 minutes and can be led by anyone – no prior medical background is necessary. Meetings start by introducing participants to the process. Then, the facilitator moves into carefully phrased questions to keep the conversation focused. For example, “Why do so many of us assume that we are getting better care when it’s newer, more expensive and involves more things being done to us?”
Then, participants share personal experiences with overuse and resistance to overuse. Finally, the discussion focuses on patient resources, including Consumer Reports’ “Five Questions to Ask Your Doctor.”
“People feel a sense of validation from the five questions,” Adams said. “Now they have a framing they can use to talk about overuse.”
So far, Baby Boomers For Balanced Health Care has organized about eight meetings—two large forums and a handful of small-group sessions—which have attracted about 150 attendees from various age groups and backgrounds. The group is now shifting from developing best practices to distributing its tools to empower others to facilitate conversations.
“We tell participants after discussions to talk about overuse with friends and family and try to be a change agent in their own world,” Doherty added. “We are working with Consumer Reports to create a new tool to help people talk to loved ones and friends when they might be dealing with potential issues of overuse.”
To learn more and to use the discussion materials in your community, contact Bill Doherty at bdoherty@umn.edu.
