I believe that innovation doesn’t always come with a high price tag. Sometimes all it takes is putting together existing tools and relationships in a new way and then taking action.
Here’s an example I am currently working on.
At a recent medical conference on leadership, I had the opportunity to hear Edwin Lindo, JD speak on the relationship between health equity and quality improvement. During this talk (which, because he is a skilled speaker, was more of a conversation) I made a note to myself that this was an area I simply must do better in, and must take specific action in—not that easy since I am fully retired from clinical practice. (I mean, how can I, a retired physician, improve health equity when I am no longer seeing patients, and no longer part of a large clinical organization?)
Well, I have kept my eyes and ears open, and with the recent signing of the Juneteenth National Holiday Bill, one old problem I wished I had addressed better in my clinical days resurfaced: how to better address evaluation of rashes in people of color (POC) at a system-wide level.
Now, obviously, the long-term solution would be to provide better dermatology training in medical school and residency. Heck, I certainly wish I had been trained better in this area 25 years ago. But, even if I could immediately change the medical school curriculum as an individual (unlikely), because of the 4-5 year time lag between student and clinician, I won’t be able to help anyone now, and improving things now is what I am interested in.
So what did I do?
Well, I decided to present a small, but a potentially scalable idea to someone by sending a $148.82 book with a small note to a friend.
Not just any book. I sent a copy of Dermatology Atlas for Skin of Color.
And not just any friend. I sent it to a friend who is the Chief Medical Officer of a clinic (one which sees > one-million patients a year) who is also an excellent clinician and a leading healthcare executive.
And not just any note. Here it is:
“Thinking about Juneteenth, your CEOs talk on innovation, wicked problems, and low hanging fruit. What if all WICs had this or a similar book, coupled with a Derm Talk? A small, non-recurring cost can make a small dent? From Matthew Rehrl”
I believe that if 20 copies of this book were bought for the 20 different Urgent Care offices, then they would be periodically looked at by the clinicians. I also believe that if these books were coupled with a talk to the group of 50 Urgent Care physicians by an experienced dermatologist on the topic of rashes of POC, then it would also improve the evaluation and documentation of rashes of POC a little more, possibly for years to come.
I also believe that this particular Chief Medical Officer—who is much more accomplished than me—will both immediately understand my idea, and, even if she doesn’t think it’s quite right, will be able to improve on it or change it. For example, maybe instead of buying 20 books for just the Urgent Care Offices (cost $2976.40) she will decide to buy 100 books for every Primary Care office. Or perhaps she is aware of a dermatologist in the system in which correcting equity deficiencies in rash evaluation of POC is their passion, and will brainstorm ways in which to improve this at scale, such as weekly email dermatology diagnostic challenges to 500 physicians and advanced care practitioners. Or maybe she will direct the creation of a CME hybrid online/in-person workshop on this topic. (Note that my skill here is identifying someone much more skilled than me!)
You see, I don’t think the key innovative step here is recognizing there needs to be systemic improvement in rash evaluation in POC. Nearly every physician I know knows that. I also don’t think providing a non-reoccurring tool such as a dermatology text book is particularly brilliant. I do think, however, that showing this idea—by sending a physical book— to the top medical decision maker in a large clinic (rather than just emailing the idea, or creating a Zoom Power Point presentation) does put this topic on the radar right now, creating the potential for some incremental change now.
Now, let’s not kid ourselves. Is this going to make a significant dent in health equity? No.
Or will this be the catalyst any deeply needed conversations on health equity? Probably not, (but, knowing this medical executive, these conversations are already taking place).
But could this help the evaluation of a rash of one or two kids each week for the next couple of years at several different clinics? Could this nudge things in the right direction, just a little?
You bet.
And that is worth $148.52.