This document discusses generating new conversations about empowering patients and partnerships between patients and doctors. It provides examples of shifting perspectives to new possibilities. The key points are: 1) Speaking into conversations in a way that provides insight rather than being seen as a threat requires understanding other perspectives and asking paradigm-busting questions. 2) Empowered patients who share information online can transform views of what information is useful and relevant. 3) New conversations are generated by understanding other views, pointing out precedents, and answering previously unanswerable questions in a relatable way.

1. “e-Patient Dave”
deBronkart
Being Heard
as Possibility
Generating a
Conversation in Medicine for
Partnership with Patients
Rochelle Frank, MD
acknowledging the support of
Lorin Bacon, NP

2. The Question:
How does one speak
into a predominant network of
conversations
in a way that occurs as insight
and not as a threat
to be defended against?

3. 2007: My “Incidental Finding”
Routine shoulder x-ray, Jan. 2, 2007
“Your
shoulder
will
be
fine
…
but
there's
something
in
your
lung”

4. Classic
Stage IV,
Grade 4
Renal Cell
Carcinoma
Illustration on
the drug company's
web site
Median Survival:
24 weeks

5. “My doctor prescribed ACOR”
(An online community of my patient peers)
Note: the ACOR group is now at SmartPatients.com

6. Equipped
Engaged
Empowered
Enabled”
“e-Patients are

8. Pt of future

9. The idea of
empowered patients
continues
to gain acceptance:

10. 2011

11. 2013

12. 2015

13. And yet many –
like the Belgian
government! –
still say “don’t google it”

14. Belgian government’s
Google Ad campaign, 2014
http://bit.ly/belgiangoogle
Insulting image
from the campaign
showing a man who
googled a symptom
and ended up
scaring himself,
thinking he had
this imaginary disease

15. What do you say
in a situation with
such conflicting views?

16. Things look different
when you shift your perspective
Source: Wikipedia, Copernican Revolution

17. Things look different
when you shift your perspective
Source: Wikipedia, Copernican Revolution
They might even
get way simpler

18. What could be said
that would make
any difference?
The question to ask if you want to
generate a new conversation:
There really is no point
saying anything else – right?

19. Also known as…
Listening for
Workability

20. First:
Get in their world.
See things as they do.

22. “How can this be,
if things are the way
we’ve been trained to think??”
Next:
Ask a paradigm-
busting question

23. How can it be
that the most useful
and relevant and
up-to-the-minute information
can exist outside of
traditional channels?
The one I use:

24. My answer slide for that question:
(The internet’s “capillaries” have
changed how information can flow)

25. Point out precedents
that they can see have been all around
Next:
“This is not new”

26. “E” is not a new idea
• Doctor Spock’s Baby and Child Care (1946)
• Our Bodies, Ourselves (1973)
“We weren't encouraged to ask questions,
but to depend on the so-called experts,”
Hawley told Women’s eNews.
“Not having a say in our own health care
frustrated and angered us.We didn't have
the information we needed, so we decided
to find it on our own.”
The one I use:

27. In short, remember:
you want to generate
a conversation

28. First
get in their world

29. “I don’t know what I said
until I know what you
heard”
A lesson from international diplomacy –
being responsible for how you’re heard

30. To transform their view,
see life as they do
and then point out
something new.

31. Answer an unanswerable question
in a way they can get
and a new view of life emerges.
The constraints the past imposes
on their view of life disappear.
Their experience of being alive
can transform.

32. This is transformation:
the genesis
of a new realm
of possibility.