The Science of Communicating Science: Dr. Susmita Pati on the Alan Alda Center’s Work

Susmita Pati – Alan Alda Center for Communicating Science

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Female : Welcome to Conversations on Health Care with Mark Masselli and
Margaret Flinter a show where we speak to the top thought leaders in
health policy , health innovation in technology and the great minds
who are shaping the health care of the fu ture. This week Mark and
Margaret speak with Dr. Susmita Pati, Division Chief of Primary Care
Pediatrics at Stony Brook Children's Hospital and Chief Medical
Program Advisor for The Alan Alda Center for Communicating Science
at Stony Brook. She talks about their successful workshops using
actors training and seasoned journalists to teach scientists and
medical professionals how to better communicate their scientific
knowledge.

Lori Robertson also checks in , the Managing Editor of FactCheck.org
she look s at misstatements spoken about health policy in the public
domain , separating the fake from the facts . W e end with a bright idea
that’s improving health and well - being in everyday lives. If you have
comments please e - mail us at [email protected] or find us on
Facebook or Twitter or on iTunes , SoundCloud or ask Alexa to play the
program Conversations on Health Care . Now stay tuned for our
interview with Dr. Susmita Pati , Division Chief of Primary Care
Pediatrics at Stony Brook and Medical Program Advisor for The Alan
Alda Center on Conversations on Health Care .

Mark Masselli : We're speaking today with Dr. Susmita Pati, Division Chief of Primary
Care Pediatrics at the Stony Brook Children's Hospital at Stony Brook
Universit y. She also serves as Chief Medical Program Advisor for The
Alan Alda Center for Communicating Science at Stony Brook
University . Prior to that, Dr. P ati was on the faculty at the University
of Pennsylvania and the Children's Hospital of Philadelphia where she
co - founded PolicyLab, a Child Health Services Research Center. She's a
recipient of the Health Care Delivery Award for her keeping families
healthy , community health worker intervention. Dr . P ati earned her
bachelor's in biochemical science from Harva rd University, her MD
from the University of Connecticut, and a master ’ s of public health
from Columbia University. Dr . Pati, welcome to Conversations on
Health Care.

Dr. Susmita Pati: Thank you so much for having me.

Mark Masselli : Well, you know, this is sort of an interesting time in health care where
in this era of evidence based scientific knowledge and we see it under
attack in so many different sectors, whether it's the growing
resistance that we've seen on vaccinations or the denial of evidence
of c limate change . S trangely to the rescue comes the legendary
American actor, Alan Alda, who's known for his role in the hit TV
series, M*A*S*H. He's also hosted a science show on PBS and it was
interesting, and Margaret, we've heard him talk about this.

Susmita Pati – Alan Alda Center for Communicating Science

Marg aret Flinter: Absolutely.

Mark Masselli : Yeah. He interviewed many scientists from the show and he
discovered that they could really use some coaching, to better share
their knowledge with the public. H e founded the Alan Alda Center for
C ommunicating S cien ce at Stony Brook where you serve as Chief
Medical Program Advisor . I'm wondering if you could share with our
listeners about the genesis of the program and how it utilizes
seasoned journalist and he lp scientist improve their communicating
skills?

Dr. Susm ita Pati: I t really came out of Alan's experience in both those arenas in acting
and also in hosting the show, which was called a S cientific American
F rontiers on PBS . H e really found that in working with folks who were
working on really complicated scient ific issues that having
conversations with them where he was using improvisational
exercises to help them get more clear and vivid in their
communication, it worked , a nd so that was the genesis of the center .
H e found that it improved not just verbal commu nication, also
nonverbal communication. Now we've trained, you know, I think it's
up to 14,000 folks in this method.

The way that it works is we use improvisational facilitators, many folks
who have a theater background to provide the training . T hen the
se asoned journalists that are involved, scientists, medical
professionals on the team, they really help develop ed the way that
these offerings are put together and then also on the e valuation side
to see , is what we're doing is working ? It's very much a team
approach and we're really proud of what we have to offer.

Margaret Flinter: Well, Dr. P ati that is so interesting. I was thinking as you were
speaking, we think a lot about translational science. We're really
talking about getting people to understand her e . T he consequences of
not communicating effectively are pretty extreme and the ability to
communicate effectively has been focused on in the education and
training of scientists and clinicians in a clinical sense perhaps, but not
in this larger scale. Tel l me a lit tle bit about what you've seen in terms
of transformation as the scientists learn to communicate more
effectively maybe share a story .

Dr. Susmita Pati: I'm happy to share some stories. I've been with the center now since
January of 20 18 . W e star ted actually prior to that having trainings at
Stony Brook Medicine with a group of healthcare professionals. It was
nurses , attending physicians, trainees, dietary aids, respiratory
therapists, and they were led by, again an improv facilitator from the
ce nter and a health care professional often myself. We ran through
these trainings over the course of about a year with about 170 folks .
Afterwards, we heard from the nursing leadership about how folks on
the floors in the hospital when they made sort of mis take in

Susmita Pati – Alan Alda Center for Communicating Science

communication, maybe they were a little too abrupt , they would do a
thing that we talk about which we call tada. Tada is sort of a thing that
you see clowns do or when they -- after they, if they make a mistake,
then they do a tada. It's a way to q uickly acknowledge that you made
a mistake and move on. The nurses and the staff were t adaing with
each other when they made those mistakes . It really has led to a
positive change in the cul ture in the way we communicate. It certainly
has helped build the team communication as well. T hat's just one
story from Stony Brook Medicine about some of what we've done.

Mark Masselli: Well, I was just trying to think about my own kids. I've got four of
them and they are very much into instant communications . I think
they're expecting their health care providers to respond like their dad
does or their mom does in terms of being there right at the moment.
I'm wondering if you could walk us through issues that today's
providers are going to face with a whole new generati on of people
who are expecting to be able to access healthcare information in a
totally different way . I'm wondering how all the method helps
providers address this sea change.

Dr. Susmita Pati: Yeah, I'm happy to talk about that. I think our approach at t he center
has really to be thinking about what do folks really want and need
from their healthcare team? I t really boils down to a lot of what folks
want as a parent , but what folks want from leaders in general, and
that's trust, compassion, stability . A ll of those things are things that
people are looking for from their health care, quality care, doing the
right thing and the right treatment . B ut to do those other things,
that's what really matters to folks when it comes to health care to feel
that they're being listened to. Our training is really focused on that
because we're aiming to train the team to communicate better so
that they can offer all of that. That is really analogous to what's
happened in other industries. I don't know if you're familiar wit h the
story of the janitor who was questioned at NASA and they asked the
janitor, what do you do here? T he janitor said, I put people on the
moon . In health care we want folks to be able to answer that no
matter what role they play on the team, that when t hey're asked
what do they do? They take care of patients.

Margaret Flinter: Dr. Pati I know in addition to your incredible work in communications,
you're also a thought leader in care transformation and particularly
improving health outcomes for pediatric patients and their families .
C ongratulations for this y ou earned the Academic Pediatric
Association ’ s Healthcare Delivery Award --

Dr. Susmita Pati: Thank you.

Margaret Flinter: -- for a program that you developed called keeping families healthy.
This is a program that provides a community health worker to families
who are at risk . Y ou're thinking was that this allows you to make a

Susmita Pati – Alan Alda Center for Communicating Science

much more accurate risk assessment of the social determinants,
which ultimately lead to poor outcomes by establishing the clini cal
presence or a clinical connection in the patients' homes. If you could
talk with us a little bit about that program and have you documented
better outcomes ?

Dr. Susmita Pati: You're absolutely right. That was the original thinking around the
program , h ow do we really understand what challenges folks face .
They go to the doctor, they get recommendations , t hey can't always
follow through . T his is a good neighbor who we train ed , the
community health worker, to go into the home and really talk with
the fami ly, understand their needs, their challenges while also
knowing what the doctor has in mind for the clinical care plan and
really help the family become self - efficient in following those
recommendations.

Since 2011, we've done more than 10,000 visits with more than 1400
families and we found that folks who participate in the program,
there's a 50% reduction in so called preventable emergency room
visits and a 16 to 20% increase in up - to - date vaccine status , s o it
works. O n the participant side, 99% of folks who participate in the
program felt that it helped them , a nd then on the provider side, they
are seeing improvements in the way that families are able to now
follow the recommendations, everything from taking their asthma
medications t o just being able ge t to appointments on time.

Mark Masselli : We're speaking today with Dr. Susmita Pati a Division Chief of Primary
Care Pediatrics at the Stony Brook Children's Hospital at Stony B rook
University. She also serves as Chief Medical Program Adviser for the
Alan Alda Center for Communicating Science . I really like the sort of
model of keeping families healthy. I know at our own, Health Primary
Care Organization, a team based care is really the direction to go. I
loved your story about the NASA Janitor , I think ev erybody on the
team needs to know the goal that they're headed. It's such an exciting
program. Wha t are key elements for those practitioners and primary
care team members who are listening in today that are our key
takeaways ?

Dr. Susmita Pati : I mean, home visiting has been around for a lot of years . I think what's
made our program particularly successful, first of all, we start with the
clinicians being the ones to make the referrals. I t's the doctor in the
office seein g the patient , and they're like th ese patient s seems like
they might have trouble following up or doing what we've asked them
to do , and they get a sense. W e asked them to go with their gut, make
a referral to us . T hen the community health worker goes in and does a
deeper dive and come up wit h ways to help the family fo llow those
recommendations. T his is a strategy that can work not just for
children of course for other populations, adult population, certainly

Susmita Pati – Alan Alda Center for Communicating Science

elder populations.

Then I think for folks who are on a lot of medications our commun ity
health workers are not clinically trained. That's where you would
think about maybe adding a nurse on top, someone that could talk
with the family on the phone. Then I think the other piece that we've
put into place that really helps it be successful i s after the community
health workers make a visit . T here's a visit summary that goes back to
the referring clinician s, s o they know what's going on, just like you'd
get a consult back from the specialist. That allows the team to figure
out, oh let's tweak it a little bit. The community health worker c an
work on that. T hen when everyone feels like the family's ready to fly
solo, then we're done , a nd so I think those are some of the key pieces.

Margaret Flinter: I want to pull it back to what goes on within t he practices. You've
been engaged in education and in research at Penn and now it's Stony
Brook and have a bird's eye view I think on the training of our health
care workforce today and also our next generation that's coming up.
What are you seeing that's different about the way we both train the
next generation within the practices to a model of what we call high
performing team based care? How do we actually train them to that
and to inter - professional care? So easy to say, harder to do, and a re
you engag ed in any research efforts to really show measurable
changes in , perhaps what we call the quadruple aim around quality
and cost , and the satisfaction of everybody on th eir team?

Dr. Susmita Pati : This is certainly we're not the only ones working on in this area. T he
National Academy of Medicine really recognizes some of the
challenges we have i n healthcare , l ots of burnout . It’s a real crisis for
the workforce and by building teamwork we rekindle that joy in work.
Most people go into health care because the y want to help people .
Tr aining folks to work together in teams to communicate well , i t really
rekindled that joy. A lot of the medical schools, nursing schools are all
looking to train students together. The training offer ed at the cent er
absolutely do th at as well l ike the story I sha red about what we've
done at Stony Brook Medicine. Then of course we're evaluating it and
I'm sure some of the listeners may have read the literature about how
Patient - Centered Medical Home recognition, how does that impact
p atient care . I t positively impacts and we certainly are engaged in
some of th at research as well to look at team science and how -- what
makes a high functioning team and then what's the downstream
positive effect patient care. We're abso lutely actively eng aged in that
work.

Mark Masselli : Dr. Pati I wonder if you have any advice for their presidential
candidates on how to effectively communicate on health policy. N ow I
see everyday s omebody ’s jumping in the -- Governor Hickenlooper
announced one of many pol iticians who are jumping in. But we ’ve got

Susmita Pati – Alan Alda Center for Communicating Science

very contentious and divisive issues around health policy about how
we communicate about that to the populations . F or those of us who
are engaged in it, we're excited about it, but it's kind of a dry topic
and it' s kind of complicated. I'm wondering how do we shift the
conversation about health policy discussion into a positive direction .

Dr. Susmita Pati : Yeah. I think most folks care about this, it affects their ability to get
health care when they need it. I thi nk people are naturally interested
in it. I think the challenge that we have in the discussions at the
moment are generally the public and people behave as if health care ’ s
are right, it's funded as a privilege. I think that's the real question, you
know w hat health care services should everyone have? I think most
folks would agree if you're in a car accident, you want -- you don't
want to have to prove that you have the ability to pay for the surgery
that you mi ght need before you can get it, so that's one question.

What about folks who get cancer? What about folks who are trying to
get pregnant and then would like to take advantage of the I n vitro
fertilization techniques that we have , and then what are the
downstream effects of that? In vitro fertilizatio n results more likely in
premature babies, children who may have other problems. Who's
paying for all of that? What about end of life care? T hese are really
challenging questions , t hey're not ones that have just a scientific or
evidence based answer. The y are ones that really speak to what are
the values that our country wants to put forward? Where did we want
to spend our money? What kinds of services in he alth care are we
going to say e veryone has the right to have ?

Margaret Flinter: We 've been speaking t oday with Dr. Susmita Pati , Division Chief of
Primary Care Pediatrics at the Stony Brook Children's Hospital and
she ’s also the Chief Medical Program Adviser for the Alan Alda Center
for Communicating Science at Stony Brook University. You can learn
more a bout their work by going to aldacommunication training.com or
at stonybrookchildrens.org and follow their work on Twitter @ Alda
Center. D r. Pati thank you so much for the work you do in advancing
pediatric care and family care and advancing the science of
c ommunicating s cience and for joining us on Conversations on Health
C are today.

Dr. Susmita Pati : Thank you so much for having me.

Mark Masselli : At Conversations o n Health C are w e want our audience to be truly in
the know when it comes to the facts about h ealth care reform and
policy . Lori Robertson is an award - winning journalist and Managing
Editor of FactCheck.org , a nonpartisan nonprofit consumer advocate
for voters that aim to reduce the level of deception in US Politics. L ori
what have you got for us t his week.

Lori Robertson: There have been six measles outbreaks so far this year , three in New

Susmita Pati – Alan Alda Center for Communicating Science

York and one each in Texas, Illinois and Washington State. Darla
Shine , the wife of Bill Shine , President Trump's Deputy Chief of Staff
for Communication , made a series of false and misleading statements
about measles and vaccines on Twitter. Shine said to , “ B ring back ”
childhood diseases .” B ecause , “ T hey keep you healthy and fight
cancer. ” Childhood diseases of course make people sick, not healthy.
They also don' t protect against cancer. While survivors gain immunity,
the same effect can be achieved far more safely with vaccines .

The Centers for Disease Control and Prevention says that even with
the best medical care, one to two of every 1000 measles patients will
die and a quarter of patients are hospitalized. Before the measles
vaccine was available in the US, an average of 450 people died every
year. Shine cited news stories about a clinical trial at the Mayo Clinic
to support her claim that measles can fight ca ncer . B ut the
researchers weren't giving patients the measles to kill cancer cells.
They were giving them a weakened version of the measles virus that's
similar to the vaccine .

Shine suggested that her children would not have lifelong immunity
because they received the vaccine instead of becoming infected with
measles as she did . Infection in some cases does result in stronger
protection than vaccines provide, but experts say that extra
protection doesn't outweigh the dangers of going unvaccinated. Shine
al so warned pregnant people not to get vaccines because of a lack of
safety testing and approval from the Food and Drug Administration.
It's true that the FDA hasn't licensed vaccines for use during
pregnancy, but there is a large body of evidence to support the use of
several vaccines.

Shine falsely said that many of the kids and the ongoing Washington
State measles outbreak had been vaccinated and called for the media ,
“ T o confirm 75% of those infected with measles in New York were
fully vaccinated . ” The ov erwhelming majority of people in both
outbreaks were not vaccinated. There are no documented cases of
measles passing it from one person to another because of
vaccination. We don't typically analyze statements made by the
spouses of political figures, but Shine ’ s claims if taken seriously could
be dangerous to public health . T hat's my fact check for this week. I'm
Lori Robertson, Managing Editor of FactCheck.org.

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Margaret Flinter: FactCheck.org is committed to factual accuracy from the country's
maj or political players and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact that you'd
like checked, e - mail us at www.chcradio.com , we'll have
FactCheck.org's Lo ri Robertson check it out for you here on
Conversations on Health Care.

Susmita Pati – Alan Alda Center for Communicating Science

[Music]

Margaret Flinter: Each week Conversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. When Venture
Capitalist and Shark Ta nk Co - Host Mark Cuban decides to sink a
couple of hundred thousands of dollars into your business idea, taking
a very small percentage of the company in return, you’re probably
onto something . T hat’s what happened to Olivier Noel, a medical
student and you ng geneticist at the University of Pennsylvania when
he appeared on the popular ABC Show. Through his research and
studies, Noel learned that no matter how many resources the clinical
study has it is still extremely difficult to get a large sample of
parti cipants to join in studies. There are many barriers to getting a
good cross section of study participants, especially ethnic diversity. H e
thought, what if you could simplify the process, eliminate the barriers
to research participation and build up a rich DNA database for future
research all at the same time, and he created DNASimple because he
wanted to make it , well , simple.

Olivier Noel: I was actually working out of the Institute of Personalized Medicine in
Hershey . O ne of the key problems that I saw t here is that it was in a
funding really amazing research projects, but ended up being a little
bit of a chasing game. We couldn't build strong enough cor ds at first
to be able to do some of the studies we wanted . Some of the patients
we were looking for , i t was taking a very long time for them to come .
E very day it would be going down and talking to the genetic
counselors and ask, did we have patients with this background today?
I ended up going to a genetics conference at Penn actually and the
keynote spea ker there was alluding to a similar problem .

O ne of the ways they were able to contact patients was th rough
Facebook , and so through Facebook they were able to connect with a
number of patients all the way in India and organize the logistics to be
able to get the samples. R eally that stuck with me and really when the
sort of the light bulb went on . I realized that that's something that we
could use and leverage. I wanted to sort of leverage the Internet, and
particularly leveraged social media to be able to build a national
database where somebody did not need to be a patient, be able to
participate in this research study.

Margaret Flinter: All of the participants have to do is to take a simple swab of the inside
of the mouth, send it in and wait to see if y our specific DNA is of
interest to researchers. No el says that the company will make their
DNA and disease data available to researchers offering those
researchers a much broader spectrum of study participants.

Olivier Noel: O ne of the things we really wan ted to do with DNASimple is to allow
for the possibility of longitudinal study so that you c ould continue
keeping contact anonymously, obviously with a particular donor . You

Susmita Pati – Alan Alda Center for Communicating Science

have the ability to collect samples now, collect samples in six months ,
which is v ery difficult to do if you are going to be in contact with a
patient once

Margaret Flinter: T he study participants themselves receive a cash stipend for off ering
up their DNA to research.

Olivier Noel: W e ultimately provide a minimum of $50 every time some body
provides a saliva sample, which they could keep for themselves or
donate it to a charity of their choice .

Margaret Flinter: DNASimple, a vetted database linking researchers with a broad array
of participants to enhance lab research by eliminating the barriers to
finding participants. Now that’s a bright idea.

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Mark Masselli: You've been listening to Conversations on Health Care. I'm Mark
Masselli.

Margaret Flinter: And I'm Margaret Flinter.

Mark Masselli: Peace and health.

Female : Conversations on Health Care is recorded at WESU at Wesleyan
University, streaming live at www.chcradio.com , iTunes, or wherever
you listen to podcasts. If you have comments, please e - mail us at
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