Shaming and degrading peers: There’s no more room [in healthare] for mean tweets and echo chambers.
Wikipedia defines the echo chamber effect as 'The echo chamber effect occurs online when a harmonious group of people amalgamate and develop tunnel vision. Participants in online discussions may find their opinions constantly echoed back to them, which reinforces their individual belief systems due to the declining exposure to other's opinions.'[2]
You know you've entered (or exited) an echo chamber in healthcare if you slink back in your chair after thoughtfully and quietly listening to several audience members (or speakers) all day and you’ve heard the cheers from the audience and listened to the types of comments they’ve made during the break. You think to yourself, 'If they only knew what I do or who I work for ... I would be run out of this place.'
Evangelism, not the religious kind, but the “rah-rah” kind isn’t new in healthcare. It's interesting to me as a writer, an advocate FOR Doctors and an observer or student of healthcare musings out there that the amount of rants by Physicians, grumpy editorials by some healthcare journalists and even former Physicians are pushing their opinions like sales pitches on LinkedIn comment threads or “X” (formerly Twitter) and repeating the same tired points about how broken healthcare is and how they have all the answers.
Years ago in college one of my communication courses discussed platitudes and echo chambers. I think this conversation is helpful and relevant for healthcare, even today.
Oxford Learner's Dictionary defines platitude as 'a comment or statement that has been made very often before and is therefore not interesting'.[1]
Wikipedia defines the echo chamber effect as 'The echo chamber effect occurs online when a harmonious group of people amalgamate and develop tunnel vision. Participants in online discussions may find their opinions constantly echoed back to them, which reinforces their individual belief systems due to the declining exposure to other's opinions.'[2]
Platitudes in healthcare are like the hair on our head. They’re everywhere, or maybe for some of you, they used to be.
For example, one popular medical publication writer wrote ... They should create more access points and include opportunities to address the drivers of health.
If we dive deeper into some echo chambers in healthcare we've probably attended without knowing it was one … a few medical conferences over the years and you thought to yourself on the plane ride home, 'Wow. I can’t believe they said that.'
ECG's principal Dr. Nick van Terheyden writes Changing healthcare in the US will require different thinking and ideas. But many of us are guilty of being stuck in our own echo chambers—interacting every day with the same people at work, in social settings, and at conferences.
The Editor of the American Association of Neuroscience Nurses, DaiWai M. Wilson wrote an editorial in April of 2020, Vol. 52, Number 2 entitled "The Dangers of Echo Chambers in Healthcare."[3] In the editorial he writes, Echo chambers likely exist [in healthcare] because they boost self-confidence. Talking to people who think like I think is very comforting. Being reassured that I have been right all along makes me feel good. Echo chambers bring a sense of fellowship and belonging. He concludes his editorial with these thoughts, ... whatever you write must be clearly written and supported by peer-reviewed evidence.
Where your perspective and mine about a few things in healthcare may divert from these places and faces in healthcare may quite possible sound like this … ‘I shouldn't have to agree with you to work alongside you in healthcare and be effective, yet right now, you're wanting me to pick a side or agree that you're right when I'm just not there yet.’ Personally, I am of the persuasion that how you and I treat people, talk about a patient, a payor, a nurse, a hospital, a system, talk to or respond to opinions that differ from our own and care for one another is our true identifying mark, not be ostracized or fear ridicule because I simply don't agree with you.
Triumph Kerins and Sekoul Krastev in September of 2022 wrote a really insightful and interesting article to peers entitled Escaping the Echo Chamber: How to Build Safe Peer-to-Peer Mental Health Platforms.[4] In the article, they write The main issue with peer-to-peer mental health communities is that they can turn into echo chambers – environments where beliefs exist unchallenged and are reinforced by the group, regardless of validity or accuracy ... Paradoxically, it is the same factors that make peer-to-peer online communities such an effective mental health tool –ease of access, normalization, and trusted peers– that occasionally make way for destructive behavior patterns.
I highly recommend you check the article referenced out. It was an insightful read on mental health and the effects of echo chambers.
I say all of this to say just one thing, be kind and open-minded to one another.
Particularly if you’re the one who finally recognizes you were one of the ones in the audience “rah-rahing”.
Working in and trying to change the world of healthcare today is extraordinarily challenging enough without mean tweets, derogatory blogs and putting a colleague down just because they deliver healthcare a bit differently from you. We don’t need more of people, your colleagues, a few of your peers or even speakers selected for certain medical conferences stating that their way is the best way to follow. Be open-minded for goodness sakes. Recognize that we all have a boulder we’re trying to push up the metaphorical mountain in healthcare and in our local community. For me, try waking up everyday and going to work and talking about the importance of customer service in healthcare and trying to find exemplary examples of that … and then sharing and telling those stories. Each day I envision pushing my burden/boulder in healthcare up the Wasatch Bench just outside Salt Lake City, Utah where I spent most of my elementary and junior high years starting at these mountains. Sometimes we’ll have people like you who is reading this come alongside and lend a hand. Other days, it feels like we’re all alone on the mountain. Isolated. Abandoned. Doing it for no reason.
If you've ever been there you know the steep slopes, the white caps up at the highest parts and how even in the summer there is still snow up there on that mountain. There will be days we’ve reached a sunny valley and other days we encounter storm clouds that seemingly came out of nowhere. We all have a goal, a mission we’re trying to achieve in healthcare by the end of our career.
As a kid, I grew up spending a lot of time wondering what it'd be like to be on that mountain.
In closing, don’t be the guy or gal who thinks he/she has all the answers and puts others down. We all blaze our own trail on the mountain. We all push our own boulder up the mountain here in healthcare. Believe it or not, we all feel alone a lot of the time, even Doctors. And yes, even when we’re surrounded by our colleagues or Patients we can feel all alone.
If a Patient was to read your comments, your posts [and that day is coming], would it change their opinion of you as their Doctor?
I get it, it’s tempting and easier to be a participant in the echo chamber. You may feel overwhelmed by emotion, comment on that thread or even affirm a colleagues rant and then share it. But please, consider what boulder they’re trying to move. Maybe it’s personal. Maybe it’s professional. The world of healthcare, especially those in primary care and family medicine needs more helping hands. So please, be kind and be considerate to those whom share your degree.
I'll leave us today with two wise statements. One from Gandalf the Gray in Lord of the Rings to his good friend and travel companion Frodo where he says ... "It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to."
The other from my pastor … “We didn’t sign up for easy. We signed up for worthwhile.”
Citations
https://www.oxfordlearnersdictionaries.com/definition/american_english/platitude
https://en.wikipedia.org/wiki/Echo_chamber_(media)
https://journals.lww.com/jnnonline/Citation/2020/04000/The_Dangers_of_Echo_Chambers_in_Healthcare.1.aspx
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