The Patient Double Bind: Revolutionary Paper Introduces New Terminology to Think about Patient Involvement in Healthcare Systems

NYU Wagner’s Patricia Satterstrom and her colleagues explain challenges multidisciplinary healthcare teams face in including patients in transformative change, offering tangible ideas for overcoming them. 

Have you ever been asked for your perspective and felt your response was the “wrong answer”? This has become a more common trend for patients as well-intentioned healthcare organizations request patient feedback, yet stumble with how to respond to the information shared.

Patricia Satterstrom, assistant professor of management at NYU Wagner, conducted a 23-month study of patient involvement with three federally qualified health center (FQHC) multidisciplinary healthcare change teams in the United States. A resulting paper, “The patient double bind: Seeking outsiders while creating insiders,” published in Social Science & Medicine expands how to frame challenges associated with structuring meaningful patient participation.

“The healthcare ecosystem has been and continues to evolve at a lightning pace,” said Satterstrom. “Well-intentioned leaders, who are juggling resource and time constraints with growing care demands, increasingly attempt to involve patients in change efforts to improve both patients’ and team members’ experiences. Our paper presents reasons these efforts have not always yielded desired results, shared language to discuss arising challenges, and concrete recommendations to more effectively support collaboration.”

 Produced with co-authors Fletcher Dementyev of Columbia University, Maura Danehey of New York University, Chancey Herbolsheimer of Texas Tech University, and Tim Vogus of Vanderbilt University, the study grew out of Satterstrom’s observations of 142 team meetings, supplemented with interviews and archival data. The resulting paper is one of the first to introduce “double bind” – i.e., receiving two or more conflicting messages and creating a situation where any potential response does not fulfill the request – to healthcare management literature.

The paper discusses patients’ journey on multidisciplinary change teams, the low frequency patient-shared ideas are pursued, the resulting dilemma for patient participants about what type of ideas are acceptable to share and which personal identities are appropriate to center, and, ultimately, whether patients morph how they show up to team or decide to end their involvement.

“Although our research focuses in the healthcare space, I hope our findings will resonate and offer benefits across industries – from educational institutions seeking more parent and student voice, to nonprofit organizations working to center constituent ideas, to local governments attempting to solicit resident involvement,” said Satterstrom.

Satterstrom studies how teams and organizations can overcome barriers to full collaboration and, ultimately, listen to and incorporate members’ voices and expertise. Her recent research focuses intimately on healthcare institutions and facilitating frontline team members’ ideas to enhance both patient care and team member satisfaction.