One of our focus areas includes improving primary care. We embrace ways to measure well-being and thriving in communities and re-envisioning primary care to maximize its capacity to recognize and, to a greater extent, address the myriad factors that impact a person’s health.
Evaluating the State of Primary Care During Covid-19
Nova Institute Visiting Visionary Dr. Rebecca Etz’s work aims to grow and articulate the intellectual foundations and guiding principles for the next generation of primary care. During the COVID-19 pandemic, Rebecca’s work with the Larry A. Green Center is highlighting the fact that systemic neglect of primary care in the United States has left this critical national resource unstable and overwhelmed.
In response to the fact that no one organization, federal funder, or national dataset speaks to the on-the-ground realities of primary care practice, Rebecca and her team’s “Quick COVID-19 Primary Care Survey” is gathering data regularly from primary care practitioners across the country. National and state policy is now being informed about the strains on this system. Read about this work in a Washington Post article from May 14, 2020.
In Summer 2020, Rebecca and her team convened the seven largest primary care clinician organizations to discuss the situation of primary care and the need for a unified voice and vision. This was the first time these organizations had ever met together. The group worked through a theoretical discussion and posted a vision of a new paradigm for primary care, “Primary Care Speaks as One.” More than 2,000 individuals and 50 organizations have signed this call to action.
Rebecca was also a contributor to an important report released by the National Academies of Science, Engineering, and Medicine: Implementing High Quality: Primary Care Report: Rebuilding the Foundation of Health Care on May 4, 2021. On May 21, 2021, the Larry A. Green Center sent a letter to the Secretary and Assistant Secretary of Health and Human Services urging the implementation of one of the report’s highest recommendations, to create an HHS Secretary’s Council on Primary Care.
Stay tuned for more updates and publications about Rebecca’s important and groundbreaking work.
Healing is facilitated through safety, persistence, and trust.
Resources support us as we heal. They include reframing, responsibility, and positivity. “Making connections enabled participants to acquire and refine resources and skills that were essential in their healing journey. People also brought their own personal strengths to the journey.”
“Connection to others was an essential part of all the healing journeys.” Humans are social creatures, and even the most introverted of us need close relationships. Friends and family add meaning and value to life and help support us, in good times and bad.
When we experience relational trauma, relationships can feel scary, but reestablishing safety and trust in relationships is where the healing happens. (To be clear, we do not mean reestablishing safety and trust with abusers, but rather finding other healing relationships.)
“When safety and trust had been established, people were able to connect with helpers. The nature of the behaviours of helpers that fostered healing ranged from small acts of kindness to unconditional love.”
Healing probably means different things to different people, but one definition that emerged from the study is: “The re-establishment of a sense of integrity and wholeness.”
Healing was an emergent property that resulted from each individuals’ complex healing journey, a result of bridged connections between resources and relationships. “…they gradually found relief from suffering and began to exhibit emergent characteristics: a sense of hope, self-acceptance, and a desire to help others—the immediate precursors to healing.”
In varying degrees, “they were able to transcend their suffering and in some sense to flourish.”
Suffering is the ongoing pain from wounding.
There is debate about whether or not one actually needs to experience suffering on the path to healing.
Wounding happens when we experience physical or emotional harm. It can stem from chronic illness or by physical or psychological trauma for which we do not have the tools to cope, or a combination of those factors.
“The degree and quality of suffering experienced by each individual is framed by contextual factors that include personal characteristics, timing of their initial or ongoing wounding in the developmental life cycle and prior and current relationships.”
Characteristics: How predisposed someone may be to wounding/how many tools and resources someone may have to deal with trauma/illness.
Lifestages: Developmental timing plays an important role in the impact of trauma — young children often do not have the same resources as older adults.
Relationships: Relationships can provide solace and support for those suffering, while lack of healthy relationships can prolong suffering.