Flipping the Clinic: The Beginning of the Beginning

Thomas GoetzBy

How do you turn an idea into something bigger? It’s necessary, but not sufficient, to start with a good idea, of course. But it also takes a community of supporters – people willing to step out of their busy day-to-day and contribute time and brainpower to turning that idea into something closer to reality.

That was the goal of the first Flip the Clinic workshop, held in mid-September at the Foundation’s headquarters in Princeton, New Jersey. We invited 15 amazing thinkers and doers from various perspectives – doctors, nurses, patients, policy makers, entrepreneurs – and asked them to spend a full day (and then some) helping us turn the Flip the Clinic idea into something substantial, or at least substantiated.

The idea was to get some honest feedback on whether the idea has legs, and some expert input on where it might go. The result, by all measures, exceeded our expectations. Not only does the Flip the Clinic idea seem to meet a clear and broad need for new thinking about healthcare delivery, but it may just offer a necessary inspiration for doing some hard but necessary work in changing it.

The key, in hindsight, was the diversity of experience in the room. We had docs, of course, including HealthLoop’s Jordan Shlain, Mass General’s Steve Atlas, and Ivor Horn, a pediatrician and research at the Children’s National Medial Center. And we had nurses such as author Theresa Brown. But we also had a few people who’ve added entrepreneur to their healthcare backgrounds, such as Khan Academy’s Rishi Desai, David van Sickle from Propeller Health, Alexandra Drane from Eliza, and John Moore from MIT and Atelion Health and Eric Ding from Harvard School of Public Health.

And then there were smart folks with a toe in the policy world, such as White House Innovation fellow Adam Dole and Kavita Patel from the Brookings Institution, and. And we had people building better tools and resources for patients, such as Rebecca Onie (from Health Leads), Sara Horowitz from the Freelancer’s Union, Dr. Yang Yang from Center for Taiji Studies, Margaret Flinter from Community Health Center, and Natasha Gajweski from Symple.

They were joined by some of the foundation’s leaders, such as John Lumpkin,  Anne Weiss, and Brian Quinn. All in all, an amazing group.

It wasn’t all roses, of course. At times, grappling with the institutional and practical and human impediments to changing the status quo, it seemed like we were might be tilting at windmills. As one attendee put it: “The approach is necessary. But the problem is herculean.” And there were plenty of counsel that any attempt to improve a human-to-human encounter tackles the biggest challenge on the planet: humans.

Judging by the number of Post-Its lining the walls of the conference room, a cascade of colored sheets enumerating unmet needs, promising strategies, and potential tools, we indeed have our work cut out for us. But as we reminded each other at the end of the day, the purpose of Flip the Clinic is not to solve the problems of healthcare in the U.S. all at once. Rather, the intention is to seed an idea that gives people a framework for understanding part of the challenge, and perhaps – we hope – gives them permission to start trying.

The goal of Flip the Clinic, at root, is simply to present an idea so clearly and powerfully that it’s more than just one blog post or website. It’s to kickstart a community around that idea, and give them a locus and a focus for starting the hard work ahead.

  • Wayne Caswell

    The biggest flip is from a Sick Care system focused on disease management to a Health Care system focused on wellness and prevention. According to HHS, preventable chronic conditions account for 90% of all health care spending. And according to the WHO, we spend twice as much as other nations but live sicker and die younger. Average life span is ranked 50th in the world, behind Guam.

    Other significant flips involve reforms in how care is delivered and paid, including smart uses of technology. The biggest impediment to those reforms is the fact that the medical industrial complex spends twice as much on lobbying as the military industrial complex. Clearly, they don’t want to lose any of their $3 trillion/year in revenue.

    Even with significant obstacles, I remain extraordinarily bullish on the future of health care. To understand why, see my comments after http://www.mhealthtalk.com/2014/03/healthcare-in-the-age-of-dr-google/.