At the Tipping Point: Changing Our World

Abstract

We need to prepare ourselves for the possibility that sometimes big changes follow from small events, and that sometimes these changes can happen very quickly.—Malcolm Gladwell, The Tipping Point Pessimist or optimist: Which are you? Our world and our society are changing rapidly, and while many people look at change through an optimistic lens, there are pessimists about change as well. I believe we must prepare for change, manage it, and make it our own, by adopting a positive attitude. The first step is to identify change as it is happening, and move to confront it. In his book The Tipping Point, Malcolm Gladwell writes that events begin to make a visible difference after a point in time when an occurrence triggers a consequence, either intended or unintended. “The Tipping Point is the moment of critical mass, the threshold, the boiling point,” he writes: The influenza epidemic of 1918, the AIDS epidemic, Hurricane Katrina—these are examples of “tipping points” in history that have significant consequences, affecting thousands or millions of people, in ways that can't always be foreseen at the time (1Gladwell M. The Tipping Point: How Little Things Can Make a Big Difference.in: Back Bay Books, New York, NY2002Google Scholar). The obesity epidemic, pressures in health care, and the economic recession have moved our profession to a crucial tipping point. Dietetics is today's go-to profession for healthy lifestyle change. Don't take my word for it: A recent CNNMoney article ranked our profession third on a list of jobs most likely to change the world for the better (2Rosato D. Wong G. Best Jobs in America: Best jobs for saving the world: 3. Dietitian.http://money.cnn.com/magazines/moneymag/best-jobs/2011/jobs-helping-others/3.htmlGoogle Scholar). It is up to each of us to adopt the attitudes needed to change our world. I asked my friend, Academy member (and my predecessor as president of the Pennsylvania Dietetic Association) Cindy Brylinsky, MS RD, LDN, to share her thoughts on how registered dietitians can best succeed in the current health care environment. Brylinsky is vice president for financial and decision support systems at Geisinger Health System in central Pennsylvania, and worked for 18 years as a clinical dietitian and clinical nutrition manager. This is a really important time,” she says. “There are people who think health care reform doesn't matter to them, but it does. Health care is moving now toward an emphasis on health and wellness more than at any other time in history, and that is how dietetics can make a difference. We need to help people recognize the value of prevention and health promotion,” which is emphasized in the landmark 2010 health reform law. Brylinsky suggests the following ways in which registered dietitians can influence reform efforts (in this case, those who practice in clinical settings): •Get in on wellness and prevention initiatives•Assure excellent patient satisfaction•Embrace electronic health records—get in on the ground floor if you don't have one already•If you are tax-exempt, identify community partners and get involved in community needs assessment programs and efforts•Prepare for growth in outpatient activity and increased acuity in the inpatient population•Network with peers•E-visits are coming, make sure you are prepared “Be a part of it,” Brylinsky encourages us all. “Don't let health reform pass you by. Whatever your area of practice, you are health reform.” How do we “become health reform”? First and foremost, as providers we must promote trust. With the Affordable Care Act of 2010, value-based decisions and quality are everyone's top priorities. My advice is: care more. Be genuinely interested. Listen. Make others feel important. You will find that goodwill, excellence, and integrity will take you far. To meet the challenges of the future, innovative ideas are needed. The world is more dynamic and less predictable, so innovation requires that we try to map the unknown and explore opportunities. Wherever you work, brainstorm ideas and encourage input from all stakeholders. Focus on your underlying needs, not your “wants,” then choose the ideas most likely to yield outcomes that provide a win-win for everyone. Finally, review your interpersonal communication style. A global, multicultural approach is needed when communicating with patients, doctors, administrators, and team members. Miscommunication often occurs when there are preconceived notions, unclear expectations, time constraints, stressors, or poorly transmitted messages. Use simple, brief, and objective messages and ask for feedback. By making changes in our attitudes and interpersonal styles, we really will change the world for the better. Our tipping point is now!