You know you’ve been in an echo chamber in healthcare if you slink back in your chair [at a conference] after thoughtfully and quietly listening to several speakers all day and hear cheers from the audience and listen to the types of comments during the break … and think to yourself, ‘If they only knew what I do or who I work for … I would be run out of this place.’
April 2023
By Michael Tetreault, Editor-in-Chief, Concierge Medicine Today & Host, Concierge Medicine Forum
It’s interesting to me as a writer, an advocate FOR Doctors and an observer and student of all kinds of opinions and healthcare musings the shear amount of rants by Physicians, grumpy editorials by journalists and former Physicians, news stories pushing opinion over substance and comment threads repeating the same tired points about how broken healthcare is and how they have the answers.
Furthermore, because no one has ever had their idea heard or shared before, they make every attempt to share their opinion but also want you to agree with them as well.
Years ago in college one of my communication courses discussed platitudes and echo chambers.
Oxford Learner’s Dictionary defines platitude as ‘a comment or statement that has been made very often before and is therefore not interesting‘.[1]
Wikipedia defines the echo chamber effect as ‘The echo chamber effect occurs online when a harmonious group of people amalgamate and develop tunnel vision. Participants in online discussions may find their opinions constantly echoed back to them, which reinforces their individual belief systems due to the declining exposure to other’s opinions.'[2]
Relevant to what you and I read and do in healthcare today, we read platitudes everywhere. For example, one popular medical publication writer wrote … They should create more access points and include opportunities to address the drivers of health.
Diving deeper into echo chambers you’ve probably attended by accident a few medical conferences over the years that when you left you just couldn’t help but say to yourself, ‘That’s crazy talk.’
ECG’s principal Dr. Nick van Terheyden writes Changing healthcare in the US will require different thinking and ideas. But many of us are guilty of being stuck in our own echo chambers—interacting every day with the same people at work, in social settings, and at conferences.
You know you’ve been in an echo chamber in healthcare if you slink back in your chair [at a conference] after thoughtfully and quietly listening to several speakers all day and hear cheers from the audience and listen to the types of comments during the break … and think to yourself, ‘If they only knew what I do or who I work for … I would be run out of this place.’
The metaphorical fear of being tarred and feathered for your views, worse yet, cancelled. That’s how you know you’ve been in an echo chamber in healthcare.
So you discretely turn over your conference badge and later hide it in your backpack for the rest of the conference.
The Editor of the American Association of Neuroscience Nurses, DaiWai M. Wilson wrote an editorial in April of 2020, Vol. 52, Number 2 entitled “The Dangers of Echo Chambers in Healthcare.”[3] In the editorial he writes, Echo chambers likely exist [in healthcare] because they boost self-confidence. Talking to people who think like I think is very comforting. Being reassured that I have been right all along makes me feel good. Echo chambers bring a sense of fellowship and belonging. He concludes his editorial with these thoughts, … whatever you write must be clearly written and supported by peer-reviewed evidence.
Where I think we all must attempt to resolve our difference with echo chambers, belong-ship and the need to be reassured is when echo chambers have an evangelistic nature at medical conferences that isolate outsiders with differing opinions to some of the same problems plaguing physicians today and in the future.
In essence, I shouldn’t have to agree with you to work alongside you in healthcare and be effective, yet right now, you’re wanting me to pick a side or agree that you’re right when I’m just not there yet. Personally, I am of the persuasion that how you and I treat people, talk about a patient, a payor, a nurse, a hospital, a system, talk to or respond to opinions that differ from our own and care for one another is our true identifying mark, not be ostracized or fear ridicule because I simply don’t agree with you.
Triumph Kerins and Sekoul Krastev in September of 2022 wrote a really insightful and interesting article to peers entitled Escaping the Echo Chamber: How to Build Safe Peer-to-Peer Mental Health Platforms.[4] In the article, they write The main issue with peer-to-peer mental health communities is that they can turn into echo chambers – environments where beliefs exist unchallenged and are reinforced by the group, regardless of validity or accuracy … Paradoxically, it is the same factors that make peer-to-peer online communities such an effective mental health tool –ease of access, normalization, and trusted peers– that occasionally make way for destructive behavior patterns.
I highly recommend you check the article referenced out. It was an insightful read on mental health and the effects of echo chambers.
I say all of this to say, be kind to one another.
Working in and trying to change the world of healthcare today is what I describe as pushing a boulder up a mountain. For me personally, I envision the Wasatch Bench just outside Salt Lake City, Utah. If you’ve ever been there you know the steep slopes, the white caps up high during most parts of the year and the sunny valleys and storm clouds that can develop out of nowhere. I grew up there and spent so much time as a kid wondering what it’d be like to be on that mountain.
Today, we all forge our own trail and push our own boulder up the mountain in healthcare. We will feel alone a lot of the time, even when were surrounded by our colleagues or Patients. It’s alluring to participate in echo chambers, get overwhelmed by emotion, comment on that thread or affirm a colleagues rant and share it.
But please, be wise. Be kind and be considerate. If a Patient was to read your comments, your posts [and that day is coming], would it change their opinion of you as their Doctor?
I’ll leave us today with some wise words that are not my own but that of Gandalf the Gray to his friend and travel companion Frodo where he says … “It’s a dangerous business, Frodo, going out your door. You step onto the road, and if you don’t keep your feet, there’s no knowing where you might be swept off to.”
- https://www.oxfordlearnersdictionaries.com/definition/american_english/platitude
- https://en.wikipedia.org/wiki/Echo_chamber_(media)
- https://journals.lww.com/jnnonline/Citation/2020/04000/The_Dangers_of_Echo_Chambers_in_Healthcare.1.aspx
- https://thedecisionlab.com/insights/health/escaping-the-echo-chamber-how-to-build-safe-peer-to-peer-mental-health-platforms
