Theory and reality: on returning from conferences

We are losing the battle for the public’s health, said Karen DeSalvo, the health commissioner for New Orleans, in one of the plenary addresses at the 35th Annual Meeting of the Society of General Internal Medicine, which just finished up in Orlando. I found her speech electrifying; the audience gave her a standing ovation.

On the day afterwards, the Secretary for Health and Human Services of the State of Massachusetts, JudyAnn Bigby, gave a speech about the realities of health care reform in her state: how payment reform and care restructuring go together. She got a standing ovation too, but the audience was informed rather than dazzled.

This is the difference between inspiring words and the grind of policy, the gap that everyone feels on coming back from a conference. The difference between your internal vow only to give the highest quality care – and the realization, on reading a specialist’s note, that a medication was prescribed to your patient without much indication. You’re going to have to wrestle with yourself. Are you going to speak up about it? Are you going to jeopardize your collegial relationship? What if the patient is convinced that the specialist did it for all the right reasons?