Thursday, June 16, 2011

Guest Commentary: A Lesson in Communications from Richard Foster

Rob Lieberthal, PhD
Faculty, Jefferson School of Population Health

I went to the Society of Actuaries Spring Health meeting in Boston to improve the quality of my research. I wanted to learn the actuarial perspective on comparative effectiveness research, learn about new SOA initiatives that I can get involved in, and find new sources of data. My plan was to improve my technical skills. The main lesson I got was an amazing perspective on the importance of communication.

Richard Foster, the Chief Actuary at the Center for Medicare and Medicaid Services, was the keynote speaker of the conference. The main theme of his speech was communicating technical results to difficult audiences. Mr. Foster’s most powerful example of a difficult audience was the Medicare administrator who tried to suppress his estimates of the Medicare Modernization Act (see his take here). He cautioned that a more common problem is that politicians can’t, or don’t want to, understand the opinions he gives as CMS’s chief actuary. His feeling is that the miscommunication is getting worse with rising partisanship. Mr. Foster works hard to make sure his estimates are not misquoted or misconstrued. He went as far as to publicly contradict then health reform director and current White House deputy chief of staff Nancy-Ann DeParle.

I have been thinking about how that standard of behavior applies to the problem of communicating the results of comparative effectiveness studies today. Many of the technical issues that held back research in the past, like computer resources or lack of data, have become less important. The communication problems have become more difficult, largely because the work we do is being taken more seriously. Richard Foster has issued a challenge not only to health actuaries but to all of us who work in quantitative roles in health care. Can we communicate our work to non-experts? And can we do it in such a way as to minimize the chance that it will be misused? I feel that answering this challenge is the key to research that is not only technically correct, but also has an impact on population health.

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