What happens when doctors move towards transparency? Q&A with Leana Wen

Physician and public health advocate Leana Wen discussed a highly controversial approach to transparency in the clinical encounter. We caught up with Leana to learn more about her ideas and actions in public health advocacy.

What happens when doctors move toward transparency?

“I want doctors and patients to come together to end the sickness of fear.” Leana Wen, TEDMED 2014. Photo: Sandy Huffaker for TEDMED

What motivated you to speak at TEDMED? I wanted to share a message to doctors, patients, innovators, and all those who are committed to transforming the future of medicine. There is no place better to do that than at TEDMED, in front of people want to learn paradigm-changing ideas and who are already motivated to take action!

Why does this talk matter now? What impact do you hope the talk will have? It’s harder for people now than ever to establish a long-term, trusting relationship with their doctor. There is a growing disconnect between what patients need and what doctors do. I explain in this talk how radical transparency will empower both patients and doctors (and other providers). I hope doctors watching the talk will choose radical transparency and voluntarily disclose both financial conflicts and personal views to their patients. I also hope patients—people—watching the talk will prioritize transparency and choose their doctors accordingly.

What were the top TEDMED2014 talks that made an impression on you? Sonia Shah flipped my conception of cause and effect, and how we may need to change the focus of public health and medical interventions. Eleanor Bimla Schwarz stopped me in my tracks to appreciate how our bodies are made, and how our efforts to interfere with normal body processes can have downstream adverse consequences. Gail Reed and Sigrid Fry-Revere challenged me away from U.S.-centric thinking to consider there is much to learn from how other countries serve patients.

What is the legacy you want to leave? I want doctors and patients to come together to end the sickness of fear. Doctors can take the first step, and let patients into our world. We can ensure patients and their families take part in all bedside rounds. We can embrace open medical records and open disclosure of medical errors. We can show vulnerability and humility with our patients. These are all steps to change the paradigm of medicine from one of secrecy and hierarchy to one that is fully open and engaged. I would love to live in a world where doctors and patients (and all healthcare providers) come together to be equal partners in medical care, without barriers or secrets or fears.

Please share anything else you wish you could have included in your talk. I wish I had more time to talk about how transparency may seem scary, but that research shows openness helps doctors as well as patients. There are studies that show collaborative medical records and open disclosure of medical errors increase patient trust, improve health outcomes, and even decrease malpractice. This will be particularly important as doctors are being measured on quality metrics like diabetes and blood pressure control. Lifestyle changes require trust, and trust requires transparency.