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OHPF Day 3

Expanding on one of the “e’s” from Day 2, this morning’s work was focused on equity. This is a term I use and explore frequently – in parenting, with patients and in lectures, I often share:

Fair isn’t everyone getting the same thing

Fair is everyone getting what they need in order to be successful

When considering the unique needs of an individual, the challenges facing a particular cohort of the population, the advantages extended naturally or artificially to certain groups, there is an art and likely scientific data involved in the appropriate application and allocation of resources. There can be a natural instinct to seek and deliver equality– dividing the pie evenly among everyone – but what if you’ve had enough pie or don’t have a plate or are allergic to the ingredients?

A key component of equity is listening carefully for specific needs, performing an assessment that truly distills down to the core issue and acknowledges that which would be most helpful in moving the needle forward for an individual or group. Success in this task requires rising above assumptions, recognizing and adjusting for implicit (or overt) biases. An assessment must then be made regarding potential resources – what is available, who are the possible providers, what are the barriers to access?

These inventories, obtained with prudence, can be compared for alignment – is there a match between that which is needed and that which exists? Is there a clear path for access? Where are the gaps? Can they be easily filled? How and by whom?

This can be a sticking point in the health care delivery system. Rules, regulations and siloed resources can create unexpected limitations to implementation and utilization. Where can we be facilitators of connection, communication whether we utilize our own skills directly or expedite access to colleagues or external programs that can more effectively serve the needs of an individual or group?

Consider extending the concept of unityin the tenets of osteopathy beyond the body, mind and spirit of an individual to the unity of the whole – community, society, world – we all get better when one gets better. A rising tide lifts all the boats. Creating equitable environments that nurture health in a unique and meaningful way for individuals contributes to the optimal health of the collective. This application encompasses both needs and resources – there is much available, many good efforts and initiatives underway but until they are coordinated, their effectiveness is muted.

Let’s stop handing out uniform pieces of pie and instead find out what people actually want for dessert, if they have the tools, time and space to enjoy a slice should they choose and certainly ensure they are aware of all ingredients so as not to suffer an adverse reaction from something they cannot tolerate or did not expect. To be clear – pie is great, pie can be fantastic, pie might hit the spot for many people. For some, however, it does not meet their needs and we shouldn’t just assume that because we have made it, everyone will enjoy.

The solution might be as simple as repurposing the ingredients already in use – a crumble or a muffin might be a better option. Some might just need the right place setting and an opportunity to sit and actually enjoy the slice being offered. Others may need something different entirely and it is time to try a new recipe. If we don’t have or cannot find the necessary ingredients, we must expand our scope of sourcing. Perhaps we have to grow it ourselves but likely it already exists and if are able to ask clearly for what we need and willing to collaborate with our neighbor, we can craft a most succulent treat that genuinely satisfies.

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