National Alliance for Physician Competence Discovery Workshop


  • The group participated in a short conversation about their thoughts that have arisen since yesterday's session. Then, Bryan gave the group an overview of the flow for the rest of the day and the three catalysts shared something about what they would be presenting this morning.


Bryan Coffman

Good morning. Who had a chance to get to Millenium Park last night?

How was it? African Dance was great. The walk over there was great and the dinner afterwards was good too.

This is a little logistical note. If you are traveling today can you please let us know if you want us to arrange travel for you? I'm passing around a sign-up sheet.


Any ideas that you had waking up this morning?

We came together to talk about a structure but as we were discussing things yesterday we went into talking about process and then into talking about fixing the health care system. There were comments made yesterday about getting some organizations to move the agenda of competency forward. How much will be personality driven or is it sustainable because it is the right thing to do?

Walking over here this morning it struck me about having relationships with other industries. I was also wondering about who is the voice that represents the healthcare industry? Who is the voice that represents the balance of who the Alliance is?

This system hass been so non-integrated before this so it is no wonder we are in the situation we are in. I was thinking this idea of will this 'structure' include the capability of us speaking with a unified voice for the healthcare industry?

That is why I raised the question about the Medical Council in Britain. We don't have a way to be a voice for policy and we haven't had a way for having the connectivity. We can't get where we want to go with the system that exists. We need a more enabling environment for doctors to practice in.

What I can't get out of my mind is the vision of the red dots and the blue dot in the middle.

What I can't get out of my mind is the vision of the red dots and the blue dot in the middle. What does that blue dot have to do regarding structure and a way of being? If we do what you said and ask ourselves what if? What if the Alliance is a pheranome path? Building that path could be something to pay attention to.

We are trained monolithically to be narrow and not to pay attention to much except the path to the food (which is improving the health of the people that come to us for care). We've been attracted to other false paths. The whole colony could be invaded by someone with a similar pheranome path.

GMP could be the pheramone path and we need to keep that alive so it becomes attractive to the rest of our colony.

GMP could be the pheramone path and we need to keep that alive so it becomes attractive to the rest of our colony.

I made this comment in some of the sub-groups yesterday. There are sciences to help us make changes. There are technologies that can help manage change. Risk benefit analysis is one of these technologies. As you consider the various options you are doing this by your gut rather then making this a science application or a technology application. You can use these technologies to begin to quantify your uncertainty and learn how that affects the longer term relationships.

Some of these risk assessment and risk management applications could be valuable.

Some of the comments have been about having a common voice and a common direction. At a time of uncertainty there is some danger because if that direction turns out to be unfit you are in trouble. Having differences and variety can be an asset. Some times engaging these differences in processes like what we've been talking about is valuable. While acknowledging this is difficult it might not be advantageous over the long run to land on a single direction at this point.

I don't think it's diversity or being in lock step.

There needs to be some overarching principles that we can agree on and individualize.

There needs to be some overarching principles that we can agree on and individualize. There needs to be some sense of the common food source.

Hopefully we will begin to reconstruct some things. There are some attractors. The food source is the GMP document. That is a clear path.

I don't think we should lose track of why we came together. How do we measure and insure the public of physician competence? How can we coordinate and ultimately make a system that is not fragmented?

I've been hearing that there are three reasons for being. One is to facilitate the dialog between the different organizations. The GMP document itself is another reason. To get the document out and get it into awareness and get people to contribute to it. That could be really valuable. Third is the other experiments you might come up with.

I find that I move from action to wisdom.

I would resist over complicating it for yourselves. There are a lot of opportunities to improve things and you could get hung up on all those opportunities.

I find that I move from action to wisdom. You start with some action and then you learn from that. Rolling out the GMP document is an action. Let's think about taking that action and learning from it - we can learn lessons that will help us figure out how to take another action and that is a good thing.

December should be part of the roll out of the GMP document.


Yesterday we talked about process. Today we will shift the dialog to be about the form. In a few minutes you will be in three groups and hear three presenters. You will hear one of those presentations and then you will shift and hear a second one. Then you will come back in here. After that you will be in five teams. The assignment will be around organization. One part is the practical legal side and that might need to be an entity. Then there are the ideas around how are you going to organize to do the things that you want to do.

Who is laying down the trail? Maybe you don't have a CEO but you have a Chief Pheramone Officer? Maybe you have a Queen? I don't know if you want to do that because the Queen is the slave of the colony.

Talk about the practical and legal thing as well as organizing to get things done.

You will hear about some of the other groups and then there will be reports. After that we will have lunch then a conversation about the rest of the day.

Before we go into the presentations we'll have each of the catalysts give you a brief introduction to what they will talk about.


We've been studying the growth of non-profits and how they go to scale and sustainability. There might be some useful and relevant things there to explore.


I'm going to talk about a broad view of complexity. One of the things is about the observer and system. Another is the complexity of healthcare in 2007. If you buy into all that how would you manage an organization?


I'm going to talk about some technologies - one is a voting algorithm that is good for large group decision making. The other is called prediction markets and how these could be used for governance.

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