Why We Revolt

Careful and Kind Care in Nonprofit Quarterly

The Patient Revolution co-founder, Victor Montori, was featured in a recent article in Nonprofit Quarterly, talking about greed, corruption, and the change necessary to realign healthcare:

Establishing trust is the heart of good medicine. But few patients and doctors experience this “caring relationship” anymore. Montori, in his book, Why We Revolt, proffers a solution: a patient revolution demanding what he calls, “careful and kind care,” delivered by a system grounded in integrity not greed. This is not a consumer movement that seeks change within existing structures. Montori is calling for a social movement, where patients—who are also citizens—rise up to say they have had enough.
— Karen Kahn, "When Money Drives Nonprofit Health, Clinician Burnout Follows and Patient Care Falls"

The View from 10,000 Feet

On her flight home from the Lown Conference last week, Mary Mack thought about Victor's essay questioning the mantra that healthcare should be more like air travel. It is a thing of beauty. Read the book and send us your musings.

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Dear Victor,

I recently heard you speak at the Lown Conference in DC and I bought your book, Why We Revolt.  I read it later that day. 

Your book is heartbreaking and beautiful and full of hope for the much needed change in the US health system. There were times, while reading your book, that I sobbed, for I have experienced both the cruelties and the transcendent kindnesses that you speak about. 

On my flight home, I was pondering your passenger/patient as a blur airline analogy;  in your book you write, "...my colleague brought up the pilot with an unexpected twist..."--  your colleague suggested that air travel would be a good template for, "quality improvement" and a, "new vision for healthcare!" Specifically, No need to know the pilot/doctor; no need to know the passenger/patient-- just streamlined efficiency. 

I had an aisle seat on the right, the very first row in coach, with the extra leg room;  just the divider was between first class and economy class. The curtain was open, so I had a perfect view and noticed all the elaborate attention given to the first class passengers. At times it seemed even over solicitous; one passenger said to the attendant respectfully, but with a bit of a sigh "don't worry, I'm absolutely fine." It was clear he just wanted to read and all the "intervention" was unnecessary (I realize there is no harm here, but still it fits). 

In the cramped spaces of coach, I noticed passengers trying to stow their luggage and move about in impossibly small spaces. Someone's bag got caught on another passenger's armrest. Someone dropped something. Someone was bigger than average. Someone in the way back of the plane found nowhere to stow their carry-on bag, and had to backtrack, jostling through the line - kind of panicked - hoping to find room, so they didn't have to check their bag. The airline attendant was displeased.  And someone was traveling with small children and was trying to work to correctly place a child's travel seat. The airline attendant cited the rules and regulations. The mom quickened her pace, trying to work with the seatbelt. A thin woman, yet her backside was blocking the aisle. 

The airline attendant became annoyed and judgmental, other passengers in line were becoming surly and grumbling, tired of the continued hold up. Cruel comments were made. 

It had become a negative and impossible environment inside that economy class section of the plane!  Passengers lacked compassion and understanding for one another, and the attendants blamed some passengers for the "unnecessary" hassles and delays. 

The passengers in coach are under cared for and the folks in first class are - from what I saw - overly cared for. 

Thank you for writing such a great book. I look forward to your next. 
All the best to you!
Mary Mack 

Panel Discussion - Monday, Dec. 18th

Citizen action

Join us Monday, Dec. 18th at 5:30pm ET

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Victor Montori MD

Paul John Scott

Monika Duitch DNP, CNP, RN

Why We Revolt

Café Steam in Rochester, MN will host an engaging panel of on the problems facing our healthcare system and the need for a new model of careful and kind patient care. We will be discussing Dr. Victor Montori’s new book Why We Revolt: A patient revolution for careful and kind care and the actions of a grassroots movement that fights back against industrial healthcare.

Victor will be joined by Paul John Scott and Monika Duitch. If you can't attend the panel in person, it will be broadcast on Facebook LIve.

It is a leap of faith to accept another's truth

This story was shared as a response to Why We Revolt. If you've got a story to share about blur or greed or timelessness or love in healthcare, reach out

 Image submitted by Paula, representative of the spirit of her story

Image submitted by Paula, representative of the spirit of her story

When my husband was nearing the end of his almost decade long push to stay alive as long as he could, given his terminal cancer diagnosis, he asked me to manage his care with nausea as the primary concern when I knew he was also in a lot of pain. 

His mind was not always clear at that point so I questioned him to make sure he meant what I heard him to say.  He confirmed his request and I did my best to quash the terrible nausea he suffered, before concerning myself with alleviating his pain. 

It was years later in my own cancer treatment I found out how debilitating non-stop nausea is and I understood.

We were in a long term fight to keep him alive.  During that time we perfected our ability to act as a team, with almost mechanical common drive, in all aspects of his healthcare.  We had also promised each other at the beginning of this journey, to be impeccably honest with each other.  

It is a leap of faith to listen to the patient's wish.

-Paula