{"id":310,"date":"2021-09-16T15:33:11","date_gmt":"2021-09-16T15:33:11","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmjleader\/?p=310"},"modified":"2021-09-17T10:31:35","modified_gmt":"2021-09-17T10:31:35","slug":"floodlights-by-rich-taunt","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmjleader\/2021\/09\/16\/floodlights-by-rich-taunt\/","title":{"rendered":"Floodlights by Rich Taunt"},"content":{"rendered":"<p><span style=\"font-weight: 400\">Why have a lightbulb moment when you can have a floodlit one? <\/span><\/p>\n<p><span style=\"font-weight: 400\">Picture it. You\u2019re out after dark. Somewhere a switch is flicked, a floodlight comes on, and your view suddenly changes. Then another lights up, and another. How you thought the world looked is now completely different.<\/span><\/p>\n<p><span style=\"font-weight: 400\">We talk about lightbulb moments: that sudden realisation or inspiration. But sometimes the metaphor is too small, a single 40w bulb not doing justice to the breadth of the light being cast. In contrast, those <\/span><i><span style=\"font-weight: 400\">floodlight<\/span><\/i><span style=\"font-weight: 400\"> moments recast the world in a different light, giving a view so sharp and clear that once seen, it cannot be unseen. These are rare, deeply personal moments. For me, Obama talking about a <\/span><a href=\"https:\/\/obamawhitehouse.archives.gov\/the-press-office\/remarks-president-barack-obama-prague-delivered\"><span style=\"font-weight: 400\">nuclear-free world<\/span><\/a><span style=\"font-weight: 400\">. Simone Biles on her <\/span><a href=\"https:\/\/time.com\/6088078\/mental-health-olympics-simone-biles\/\"><span style=\"font-weight: 400\">mental health<\/span><\/a><span style=\"font-weight: 400\">. Fred Laloux on <\/span><a href=\"https:\/\/vimeo.com\/user22829990\/review\/142657836\/ed186a1f47\"><span style=\"font-weight: 400\">Teal organisations<\/span><\/a><span style=\"font-weight: 400\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Enter Victor Montori &#8211; diabetes doctor from Lima, based at the Mayo Clinic in Minnesota, and with us last week in London. Through his <\/span><a href=\"https:\/\/patientrevolution.org\/whywerevolt\"><span style=\"font-weight: 400\">writing<\/span><\/a><span style=\"font-weight: 400\">, and the <\/span><a href=\"https:\/\/patientrevolution.org\/\"><span style=\"font-weight: 400\">non-profit<\/span><\/a><span style=\"font-weight: 400\"> he leads, Victor advocates the need for careful and kind care, a wholesale revolution of how healthcare should be. \u201cCaring is not meant to be efficient, it is meant to be elegant\u201d Victor writes.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">During his visit, Victor was switching on floodlights at a ridiculous rate, describing a revolution which is evolving, growing, opening up new ways of thinking.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Three new vistas stood out for me.<\/span><b><\/b><\/p>\n<ul>\n<li><b>Care giving\u2019s role in society<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Victor\u2019s manifesto starts with the need to put <\/span><i><span style=\"font-weight: 400\">care<\/span><\/i><span style=\"font-weight: 400\"> back into health<\/span><i><span style=\"font-weight: 400\">care<\/span><\/i><span style=\"font-weight: 400\">. Yet the act of caring, as both a personal and professional act, needs to be valued by society in a completely different way.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cLet\u2019s make caring sexy again,\u201d Victor says, articulating a world where the greatest honour is not to make money or titles, but to be seen as a caring person. \u201cWe have outsourced our need to care to immigrants and women of colour,\u201d Victor says starkly.<\/span><\/p>\n<p><span style=\"font-weight: 400\">To rethink medicine isn\u2019t to start with students and curriculum, but with those much younger. \u201cCovid has shown us a world where we stand in the streets and cheer for care-givers. For our children this cannot be taken back.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">In this way the title of Victor\u2019s book &#8211; the need for a patient revolution &#8211; has been outgrown. This isn\u2019t really about patients, or the healthcare encounter, but the communities in which we live.\u00a0<\/span><b><\/b><\/p>\n<ul>\n<li><b>Change the soil<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Little of what is articulated in Victor\u2019s book <\/span><a href=\"https:\/\/patientrevolution.org\/whywerevolt\"><span style=\"font-weight: 400\">Why we Revolt<\/span><\/a><span style=\"font-weight: 400\">, the English programme of <\/span><a href=\"https:\/\/rethinkingmedicine.org.uk\/\"><span style=\"font-weight: 400\">Rethinking Medicine<\/span><\/a><span style=\"font-weight: 400\">, or its Celtic counterparts <\/span><a href=\"https:\/\/www.realisticmedicine.scot\/\"><span style=\"font-weight: 400\">Realistic Medicine<\/span><\/a><span style=\"font-weight: 400\"> and <\/span><a href=\"https:\/\/gov.wales\/sites\/default\/files\/publications\/2019-04\/securing-health-and-well-being-for-future-generations.pdf\"><span style=\"font-weight: 400\">Prudent Healthcare<\/span><\/a><span style=\"font-weight: 400\">, is new. We have been talking about shared decision making for decades. Aristotle knew a thing or two about wellbeing and prevention.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">In the NHS we do not lack for initiative after programme after taskforce to try and make a shift away from the status quo. Yet the fact we try all of this \u2018new\u2019 is a sign that the soil which we are trying to cultivate is so hard that we have given up trying to change it.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Instead, we opt for the path of least resistance: a shanty town of projects and pilots, \u2018change days\u2019 and commitments, all of which lack the muscle to do more than scratch the surface. \u201cWe cannot see this as a process of incremental change,\u201d Victor said, acknowledging some may disagree. \u201cIt requires fundamental change of what we think we\u2019re here to do.\u201d\u00a0\u00a0<\/span><b><\/b><\/p>\n<ul>\n<li><b>This might take a while&#8230;.<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Feeling daunted by any of this yet? Join the club. This isn\u2019t a task which is quick; I\u2019ve previously written about the need for a <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/01\/29\/richard-taunt-rethinking-medicine-a-longer-term-plan\/\"><span style=\"font-weight: 400\">100 year plan<\/span><\/a><span style=\"font-weight: 400\">. The fruits of our labours now may only be felt by our children, or their children. 2100 seems far distant, but over 10% of the UK population then is alive today. Just sent your child to school for the first time? There\u2019s close to a 3 in 4 chance they\u2019ll get to party like it\u2019s 2099.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">We need to recalibrate the interventions which will make the long-term difference while not forgetting we need to start somewhere. If we make 1% of the change a year, in 100 years we get there &#8211; so what\u2019s this year\u2019s 1%?\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">And even working at that rate, the chances of it working are slim. \u201cI know exactly our chance of success,\u201d Victor proclaimed. \u201cIt\u2019s 7%. But what else would we rather do with our time?\u201d This is how change happens. \u201cNever doubt that a small group of thoughtful, committed citizens can change the world\u201d wrote Margaret Mead. \u201cIndeed, it&#8217;s the only thing that ever has.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Speaking to an audience in London,Victor invoked <\/span><a href=\"https:\/\/www.youtube.com\/watch?v=3vqwrepaMR0\"><span style=\"font-weight: 400\">Hamilton<\/span><\/a><span style=\"font-weight: 400\">: \u201cRaise a glass to the four of us \/ Tomorrow, there&#8217;ll be more of us \/Telling the story of tonight.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">If you agree with the bright illumination Victor gives, and the revolution ahead, what part in this story do you want to play? At Kaleidoscope, we\u2019re in. What about you? Comment below, or <\/span><a href=\"https:\/\/patientrevolution.org\/donate\"><span style=\"font-weight: 400\">join the revolution<\/span><\/a><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"attachment-266x266 size-266x266\" src=\"http:\/\/blogs.bmj.com\/bmjleader\/files\/2021\/09\/Rich-Taunt-pdf.jpg\" alt=\"\" width=\"199\" height=\"266\" \/><\/p>\n<p><strong>Rich Taunt<\/strong><\/p>\n<p>Rich Taunt is the founder of Kaleidoscope Health and Care, a not-for-profit social enterprise which brings people together to improve health and care. Kaleidoscope works with a range of NHS organisations, charities, and others, to find new solutions to old problems. In previous lives, Rich held senior positions at organisations including the Department of Health and Social Care, the Health Foundation, and the Care Quality Commission. Web:\u00a0<a href=\"https:\/\/www.kscopehealth.org.uk\/\">kscopehealth.org.uk<\/a>\u00a0Twitter: @richardtaunt<\/p>\n<p><b>Declaration of interests<\/b><\/p>\n<p>I have read and understood the BMJ Group policy on declaration of interests and declare the following interests:<\/p>\n<p>Rich Taunt works at and owns shares in Kaleidoscope Health and Care, a Community Interest Company regulated by the Office of the Regulator of Community Interest Companies. Kaleidoscope Health and Care and the Nuffield Trust were commissioned by Imperial College Healthcare NHS Trust to conduct the user research referenced in this article. No payment was received for this article.<\/p>\n<p>*This blog was revised 17th Sept 2021 to include changes to headings.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Why have a lightbulb moment when you can have a floodlit one? Picture it. You\u2019re out after dark. Somewhere a switch is flicked, a floodlight comes on, and your view suddenly changes. Then another lights up, and another. How you thought the world looked is now completely different. We talk about lightbulb moments: that sudden [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmjleader\/2021\/09\/16\/floodlights-by-rich-taunt\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":395,"featured_media":311,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-310","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/bmjleader\/wp-json\/wp\/v2\/posts\/310","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/bmjleader\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/bmjleader\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmjleader\/wp-json\/wp\/v2\/users\/395"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmjleader\/wp-json\/wp\/v2\/comments?post=310"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/bmjleader\/wp-json\/wp\/v2\/posts\/310\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmjleader\/wp-json\/wp\/v2\/media\/311"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/bmjleader\/wp-json\/wp\/v2\/media?parent=310"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmjleader\/wp-json\/wp\/v2\/categories?post=310"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmjleader\/wp-json\/wp\/v2\/tags?post=310"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}