We cross many thresholds in our health journeys: before the diagnosis / after the diagnosis; outside the office / inside the office; before the pain / after the pain; having enough money / having too little money; before being cared by xxx / being cared by xxx; in control / less control; before taking the drug / taking the drug; before surgery / after surgery; walking fine / problem walking; living here / living there, etc. etc. Thresholds of sensations, function, location, relationships, power, information. Disorienting and bewildering – at least unsettling, sometimes devastating. And that ‘s just for us e-patients. What about our family, caregivers, and the professionals in and associated with our team? A veritable ripple of thresholds.
Being a host at some thresholds can be very helpful. Welcoming, including, informing – As simple as Hi Mike, I’m Danny. Welcome to …. Listening, informing, sharing, collaborating, caring, recognizing – these all help reduce the unsettling of thresholds. Most customer service programs address these courtesies. I learned this from my parents.Simple, remindful of what we know to be expressions of the golden rule, but easy to space out in the flow and challenges of the day. My friend, Cristin Lind, writes eloquently about the threshold of moving in her Durga’s Toolbox post (link here)
Harder threshold smoothers are reducing power and information disparities. Power disparity can be the child-parent relationship that appears frequently in the health journey – feeling smaller. I work at Advocates, Inc. (link here) We frequently consider the power disparity between clients and caregivers.Our philosophy is expressed in the Advocates Way (link here). One of the sections is headed Using Power Honestly, Wisely and Respectfully. Recognizing power disparity is the first step in managing the thresholds involving power dynamics. Information disparities are primary topics in two other circles I inhabit: The Society for Participatory Medicine (link to S4PM) and Health Information Management Systems Society (HIMSS link) eConnecting with Consumers . You can find discussions within the websites of both organizations, especially in S4PM’s shared decision-making thread (link here) and HIMSS’ Patient Engagement Podcasts (link here).
Notice how many thresholds you cross today. What has been your experience crossing thresholds in your health journey?