MS. BECHTEL: Might have the funding for it, huh? A neurologist told me that when you hear a new idea, it fires the same receptors as pain in your brain. So I was feeling a little bit of pain in David’s presentation, but I don’t want to dismiss it because I get the point. All it takes is the one doc practice who everybody suddenly realizes they’ll see patients after hours, they post their prices on their website. We have little teeny examples here and there of people doing that.

And I think it is really notable to point out what Tresa said, and what Chuck Alston also said in his public comment, that for the first time just in the last year or two, they’re really sensing a bigger or deeper anger and frustration with cost issues and that there may be kind of a change on the horizon.

So, I’ll say before we wrap up, maybe we got the agenda order backwards. Maybe it has to be the research pathway first to set the stage and provide the evidence for shared decision making, which is how we’re going to get ultimately to value. So we’re going to wrap up and turn it back to our host Michael McGinnis here. But before we do that, any burning comments from our panel?

MR. LEVIN: Just one comment I want to make. I think it’s important to keep in mind the rapidity of change right now; we’re in a world of rapid change. And a lot of what we have talked about is today, and not about tomorrow. And so by tomorrow, what we talked about today will be out of date. It’s a new paradigm of thinking that we really have to be thinking far down the road. We have to deal with today’s problems, but we have to deal with tomorrow’s problems even more. So we need to really always be doing that stretch.

And as people have mentioned, we have a whole new generation coming up who doesn’t have a laptop like I do or a desktop, but really a device in their pocket. And it’s the way they get information. They go out to a restaurant, they don’t read a magazine; they look it up, get the rating.

So, we just have to bear in mind the rapidity of changes is overwhelming. And we really have to sort of train ourselves to say whoops, we’re thinking in today’s world and we really need to think about what tomorrow’s world is going to look like.


MS. BECHTEL: I want to say two thank yous. One is to the planning committee members, not just those up here on the stage, but those in the audience, if you want to stand and we can recognize everybody. And I also want to say thank you to our host, the Institute of Medicine and Michael McGinnis for his passion and commitment, and the staff for their support. We’re very grateful for your interest in the topic. Thank you.

DR. MCGINNIS: Thank you, Christine, and thanks to all of you. This has been an extraordinarily rich and stimulating set of discussions, informed, directed, and inspired, as Susan said, by the patients who are here to help lead the discussion. In many ways, it has been a pioneering activity for the Institute of Medicine and the National Academies in focus, in scope, and in importance.

This workshop embraces the central challenges that face the health care system today—better outcomes, lower costs, faster progress—and it has done so by seeking the Holy Grail of motivating and mobilizing the people who are served by health and health care in our nation as drivers for change—how can we democratize and grow the influence of people on care improvement, on lower costs, and on quicker progress? Not surprisingly, when pursuing a holy

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