March 10, 2025 gsilvera American Patient Series, Healthcare

The Enduring Legacy of the Radium Girls’ Fight

March brings Women’s History Month and Daylight Savings Time—two reminders of how time and social movements shape our lives. Daylight Savings, once a controversial shift, required collective action to take hold. Women’s History Month, too, is the result of tireless advocacy, bringing long-overlooked stories into the light.

One such story is that of “The Radium Girls”, whose fight for justice reshaped workplace safety, healthcare protections, and medical ethics. But beyond their tragic suffering lies a powerful lesson for healthcare leaders today—a lesson in the lasting glow of social movements.

The Radium Girls and the Cost of Ignored Warnings

In the early 20th century, young women working in radium dial factories painted glowing numbers onto watch faces, unknowingly poisoning themselves in the process. Encouraged to lick their brushes to create fine points, they ingested deadly radium day after day. When their teeth fell out, their bones ached, and their jaws disintegrated, their employers dismissed their pain.

But they fought back. Their legal battle—chronicled in Kate Moore’s The Radium Girls: The Dark Story of America’s Shining Women and later adapted into a feature film—wasn’t just about their own suffering. It forced industries to reckon with their negligence, leading to landmark workplace safety protections and medical ethics reforms.

Their legacy is chilling. Even today, a hundred-ish years later, their skeletons still glow in the dark—a haunting reminder of how long injustice lingers when ignored.

Social Movements and Healthcare’s Reckoning

The Radium Girls’ fight wasn’t just about them; it was about changing the system so that no one else would suffer the same fate. Social movements have always shaped healthcare, and recent history is no different.

The summer of 2020—sparked by the murder of George Floyd—forced hospitals and health systems to publicly acknowledge racial disparities in healthcare. Many made commitments to diversity, equity, and inclusion (DEI).

Healthcare cannot afford to ignore the power of social movements. As my own research on diversity value signaling in U.S. Hospitals (Cole, Haun & Silvera, 2022 ) and hospital board diversity (Silvera, Erwin & Garman, 2023) shows, organizations that meaningfully engage in diversity efforts aren’t just checking a box—they are responding to real needs within their workforce and patient populations. Including adding novel c-suite executive roles related to diversity equity inclusion and belonging that seek to address everything from workforce DEI and community engagement to health equity and health disparities (Hogan et al, 2023) mostly taking some variety of the title Chief Diversity Officers (CDOs).

As time passed, so did the urgency. Counter-movements—from “All Lives Matter” to the rise of anti-woke rhetoric—pushed back. Some companies have rolled back DEI initiatives, fearful of backlash.

But just as quickly as institutions leaned into DEI (Diversity, Equity, and Inclusion), a series of counter-movements have emerged. All Lives Matter ended up being more of a response to Black Lives Matter than a movement, but the Anti-Woke movement was much more sophisticated. It has effectively targeted state and federal government programs to push back on targeted DEI initiatives, labeling them as anti-American and anti-democratic. This too, is a social movement, whether it is based in fact or opinion, it has found favor in sectors of the population. And, as a direct result of this social movement, companies across industries are rolling back their diversity initiatives. Many of the executives with the title “CDO” in 2020 across sectors have adopted new titles or left their roles entirely. This social backlash has led some organizations to soften or abandon their commitments to DEI altogether. The result? A healthcare sector caught between progressive social movements and pushback social movements.

Social Movements Aren’t Abstract—They Walk Into Our Hospitals

For healthcare leaders, these shifts aren’t theoretical debates. They show up in real interactions, with real patients and providers:

Patients Refusing Care Based on Provider’s Ethnicity: Dr. Esther Choo, an Asian-American emergency room physician, has shared experiences where patients refused her care solely because of her race. She notes that this form of discrimination isn’t isolated but occurs across various states and settings. abc7chicago.com
Violence Against Healthcare Workers: Incidents of patients attacking healthcare staff have been on the rise. (Meese et al, 2024) For instance, a nurse in Florida was nearly beaten to death by a patient, highlighting the increasing dangers faced by medical professionals. people.com
Challenges in Accessing Gender-Affirming Care: Legal battles continue over access to gender-affirming healthcare for transgender individuals. For example, a federal judge recently extended a nationwide block on executive orders that aimed to halt federal funding for providers offering such care to transgender minors, underscoring the contentious nature of this issue. apnews.com

These real-world examples underscore the profound impact of social movements and societal biases on healthcare delivery. They highlight the urgent need for healthcare leaders to address these issues proactively, ensuring that all patients receive equitable care and that providers work in a safe, respectful environment.

Paying attention to social movements, is not about politics, at least not in the health care industry. All social movements give us an opportunity to refine our understanding of the human condition. Some things change with the times and others should never waver, and this is where health care and its leaders have an opportunity to shine. The unwavering value in health care is human dignity. And the question that always lies before health care leaders is whether they will stand up for dignity and support its accompanying values of respect, healing, and inclusion. How do we honor the dignity of our patients without dishonoring our providers? How do we affirm the dignity of our staff without shaming our community? It is no easy task, but it is the essential task.

Looking for the Glow

The Radium Girls remind us that some movements don’t fade. Their skeletons still glow in the dark, a stark symbol of how justice ignored does not disappear—it lingers.

The same is true in healthcare today. Social movements will continue shaping our field, whether we acknowledge them or not. The question for healthcare leaders isn’t whether these forces exist—it’s whether we’re paying attention.

Like the Radium Girls, social movements leave their mark—their impact doesn’t fade. As leaders, we must choose: ignore the glow or let it guide us forward.

March 4, 2025 gsilvera American Patient Series, Blog, Healthcare

Will Hospitals Go the Way of the Mega Mall?

This week, health information leaders are gathering at HIMSS, discussing the role of technology in healthcare. And it has me wondering: What role has technology played in shaping the American patient? More importantly, how will it continue to reshape the way we deliver care?

Hospitals have long been the backbone of healthcare delivery, but history shows that no model is permanent. With each technological advance, patient expectations have shifted—and healthcare has had to adapt.

But are we adapting fast enough? Or are we at risk of becoming the next obsolete institution, much like another once-thriving American staple: the shopping mall?

From House Calls to the “Doc in the Box”

Technology has always reshaped healthcare delivery.

When phones became widely available, we transitioned from house calls to traveling doctors who would use a patient’s phone to call prescriptions into their office. As care centralized, patients called to book appointments instead of waiting for doctors to come to them. At the turn of the century, urgent care centers (the “doc in the box”) emerged—some people raved about the convenience, others resisted… and then many of those resisters opened their own. Today, freestanding emergency rooms are the latest iteration of convenience-based care, giving patients hospital-level services without the traditional hospital setting.

Each of these shifts was driven by technology and consumer demand. But what happens when demand shifts again?

A Walk Through the Empty Mall

Not long ago, I found myself walking through a mall—a place that once defined my youth.

Growing up in the 80s and 90s, the mall was everything.

It was where you shopped, where you socialized, where you spent hours just existing with friends.

If I had $10 in my pocket, I was a king—whether I spent it on an arcade game, an ice cream, or a movie ticket.

But today? Malls are ghost towns.

Sure, they see crowds around the holidays, but the average visit now is a pit stop at the return counter. Online shopping has rendered them nearly obsolete.

Why browse for what I need when I can order in seconds and have it delivered tomorrow or even within hours in some cities.

And it’s not just Amazon anymore. TikTok Shop is the new flea market, where influencers convince us we need everything from collapsible blenders to cat vacuums. (I’m not judging, but I’m totally judging.)

The point is: We moved on.

Why do we assume hospitals are immune to the same fate?

Could Hospitals Become the Next Mega Mall?

Every semester, I ask my students:
Will hospitals soon go the way of the mega mall?

Their answer is always an emphatic NO.

But, why not?

Hospitals, in their current form, haven’t always existed. Most of the freestanding hospitals we know today were built thanks to the Hill-Burton Act in the mid-20th century. Before that, care was delivered in homes, small clinics, and charity institutions.

Today, we assume hospitals are too essential to disappear. Or dare, I say it, too big to fail.

But retail stores were once essential, too. So were travel agencies. So were Blockbuster stores. And yet, we moved on when a better option became available.

The better option is already emerging in healthcare. Patients are signaling their preference for alternatives—and some health systems are paying attention:

Many patients today prefer to take an Uber to the ER instead of an ambulance. Some hospitals have evolved, adding rideshare zones and partnering with Uber Health and Lyft Med to support patient transport.
Telemedicine and home-based care are growing—not just because they’re cost-effective, but because patients and providers prefer them.
Amazon and Walmart are entering healthcare, exploring ways to deliver primary care directly to patients and gaining efficiencies in pharmaceutical management as well.

The healthcare mall is already changing. The only question is: Will we adapt fast enough?

Technology Has Always Changed Healthcare—And It Always Will

Hospitals will never disappear entirely. Just like malls still exist. But they will not always be the dominant model in health care delivery as they once were. Interestingly, even while searching for images for this post, the terms “futuristic medicine” almost always centers on an inpatient setting and often doesn’t include an image of patient. And, if I had to paint my version of a dystopian future, that is exactly what it would looks like, a group of clinicians staring at a holographic image and absent a patient or concern for the human behind the images.

We can’t expect technology to change every other industry while leaving healthcare untouched. And, we must take patients lead on how technology will or won’t change our industry. Otherwise we’ll end up just like the kiosk salespeople in the mall today desperately hawking cat vacuums to anyone we can convince needs them. (I told you I was judging).

February 24, 2025February 25, 2025 gsilvera American Patient Series, Healthcare

From Theme Parks to Seamless Care: What Healthcare Can Learn from Disney

Recently, I had the opportunity to tour a local hospital that has the distinction of being both academic medical center and safety-net hospital. We spent a lot of time examining patient flow and emergency department overcrowding—and I couldn’t help but think about Disney World.

“Wheelchair Person” by Direct Media/ CC0 1.0

Disney is a master of movement—orchestrating guest flow through its parks so that everyone gets to the right ride, restaurant, or show with minimal frustration. For many years, patient experience gurus lauded this model for its highlighting the experience while waiting. The waiting room is an experience, the exam room is another, and then the interactions with the care providers, all of them contributing to the overall experience especially in doctor’s offices. But, lets get real— no one enjoys the TVs playing HGTV non-stop for hours on end. I could go on forever on my distaste for doctor’s office waiting rooms, but it seems hospitals are doing much of the same.

On my visit, I learned of several patient flow innovations:

A patient flow coordination room, what they called an “air traffic control room” that tracks every patient—incoming, outgoing, and waiting.
Overflow areas designed to help absorb surges in emergency visits, with plans for even more capacity.
A discharge lounge which holds patients who are medically ready to leave but waiting for transportation.

"Air traffic control" Patient Command Central — “Air traffic control” Patient Command Central photo by G. Silvera

There’s an entire logistics operation designed to move patients efficiently. The ethos, if I understand it correctly, is sound and perhaps even noble. Patients who need care should be able to access care and if there is a patient that no longer needs care or can be better taken care of at another level, we need to move them along to open up space for the next patient. But here’s the thing: everywhere is full at every level.

We have pioneered systems to improve intake, and still, patient overflow is an issue. Every innovation that I have seen to address patient flow ends up butting up against the same reality, at some point, there is nowhere else to send the patient. We have organized too many of our systems in this country for the next patient, and, far too often, we have done so at the expense of the patient in front of us.

And I’ll say it again, because it is worth repeating, the queue is not the patient.

Disney Wants to Keep People Moving. Healthcare Shouldn’t.

Crowds line the way to Cinderella Castle at the Magic Kingdom.Credit...Joe Burbank/Orlando Sentinel, via Associated Press — Crowds line the way to Cinderella Castle at the Magic Kingdom. Credit…Joe Burbank/Orlando Sentinel, via Associated Press

Disney’s goal is to keep you flowing through different experiences—moving from ride to ride, maximizing time in the park. Hospitals should have the opposite goal:

🚫 Minimize unnecessary patient movement
🚫 Keep care as close to the patient as possible
🚫 Ensure every transfer serves a real purpose

What Healthcare Can Learn from Disney+

Think about how Disney changed retail strategies.

Disney Stores once brought the magic to malls
Now, Disney+ brings the magic directly to homes

Healthcare is undergoing a similar transformation:
✔ Telehealth eliminates the need for travel
✔ Home-based care brings services to patients
✔ Hospital-at-home models provide inpatient-level care outside traditional walls

Yet, inside hospitals, we still shuffle patients around— transferring them between rooms, waiting areas, departments, and even hospitals. To what end? What is the meaning behind the movement? Is it for patient’s needs or someone else’s?

What If We Built Minimally Disruptive Hospitals?

There’s a concept called “Minimally Disruptive Medicine” that focuses on reducing the disruption of medical visits—especially for elderly patients who rely on caregivers for transportation and support.

What if we applied this thinking inside hospitals?

Fewer unnecessary transfers
More bedside diagnostics and treatment
Care moving to patients, instead of patients moving to care

I am not sure what it would look like exactly, but I have an image of care providers moving through a patient room rather than patients moving through the hospital. For the clinically inclined, what if instead of being the blood that pumps through the hospital, patients were the heart. I encourage us all to think more critically about how disruptively care is currently modeled. Because in the end, patients are not guests in our hospitals.

We are guests in their lives.

“Caregiver Nurse” by Direct Media/ CC0 1.0

What Do You Think?

Are we designing hospitals for operational efficiency instead of patient dignity? How can we make hospital care less disruptive and more patient-centered?

Drop your thoughts in the comments—I’d love to hear your perspective.

#PatientExperience #HealthcareLeadership #MinimallyInvasiveCare #HospitalFlow #PatientFirst #Disney #HealthcareInnovation

February 17, 2025February 17, 2025 gsilvera American Patient Series, Healthcare

The Monarchy of Healthcare: Empowering Patients

No Majority Rule in Healthcare—Only Patients Rule

A Presidents’ Day Reflection on Power, Leadership, and Patient Sovereignty

Presidents’ Day is a celebration of leadership, democracy, and the legacies of those who have shaped the nation. It’s a day when we reflect on the power of the people, the weight of majority rule, and the impact of decisive leadership.

Lincoln Financial Foundation Collection, courtesy of the Indiana State Museum

And yet, for all the ways we govern our country through elections, majorities, and laws, there is one place where majority rule does not apply—healthcare.

In politics, 51% can dictate the course of the country.
In healthcare, only one vote matters: the patient’s.

Because in healthcare, there are no presidents. Only monarchs.

Healthcare is a Monarchy

Yes, despite all the tea dumped into Boston Harbor, despite the Constitution’s rejection of kings, the American healthcare system operates under a different kind of rule.

The patient is sovereign.

Patient in a crown

Not as a collective majority. Not as a voting bloc. But as an individual ruler over their own body, their own decisions, their own care.

For decades, the patient-centered care and patient experience movement have fought against an impersonal, market-driven healthcare system and demanded that patients be recognized as individuals with dignity, autonomy, and rights.

While policy, insurance, and provider shortages all play their part, the reality is:
Nothing happens in healthcare without the patient.
Care isn’t dictated by the government.
It isn’t dictated by hospitals or insurance companies.
It happens when the patient deems it necessary.

And that power—the ability to decide when, where, and how one receives care—is sacred.

The Difference Between Presidents and Patients

Presidents are elected by a majority.
Patients receive care regardless of popularity.

Presidents serve four-year terms.
Patients hold a lifelong rule over their own health.

Presidents can be removed from power.
Patients, no matter their choices or circumstances, never lose their right to care.

In healthcare, there is no term limit on dignity.

There is no approval rating that determines whether someone deserves medical attention.
There is no electoral college deciding who gets access to treatment.

There is only one guiding principle: Every patient is a ruler in their own right.

Patient as king

Are We Serving Our Monarchs Well?

Of course, not every ruler is perfect.
Some make poor health decisions.
Some struggle to navigate the system.
Some lack access to the care they deserve.

But that does not mean their sovereignty should be questioned.

The greatest failures in American healthcare history have happened when we ignored the one true monarch: the individual patient.

From the Tuskegee Syphilis Study to forced sterilizations, the darkest moments in our healthcare history stem from denying patients their autonomy.

This is why informed consent is not just a legal formality—it is a moral foundation.
It is why dignity must always come first—above efficiency, above policy, above cost-cutting measures.

Tuskegee Experiment Photo from National Archives

This Presidents’ Day, Let’s Ask the Right Question

Today, many will debate which presidents were the greatest.
Some will argue about who should be in power next.
Others will reflect on the state of democracy.

But in healthcare, the real question isn’t who should lead—we already know the answer.

The question is: Are we serving our monarchs well?

Are we truly listening to patients, or are we making decisions for them?
Are we honoring their sovereignty, or are we treating them as subjects in a system they can’t control?

Because if we fail to serve our monarchs properly, we risk rebellion—not in the streets, but in mistrust, disengagement, and avoidance of care.

And a kingdom without its rulers? That is a system doomed to fail.

This Presidents’ Day, as we celebrate the power of leadership, let’s not forget the one unshakable truth in healthcare:

Patients reign. And it is our duty to serve their majesty well.

February 7, 2025February 7, 2025 gsilvera American Patient Series, Healthcare

A Pinch of Salt, A Lifetime of Impact: What Health Systems Can Learn

Early in my time in Happy Valley, as a doctoral student in Penn State’s Health Policy and Administration program (We are!), I became curious about how—and how well—our health care systems respond to us. Maybe it was the stark cultural shift I experienced moving from Miami, FL, to central Pennsylvania.

Growing up in Miami, I was used to a rich mix of cultures, traditions, and ways of living. Central PA, by contrast, felt like a single, inherited culture—one shaped by Pennsylvania-Dutch traditions, where people were kind but largely uninvolved in each other’s lives. (I was there during the Sandusky scandal, so, yeah, secrecy was part of the monoculture.) There was a quiet “to each his own” sentiment that felt completely new to me.

But my first real cultural shock didn’t come from social norms—it came from the food.

The Salt Shaker Moment

I’m far from a foodie, but I do appreciate good food. Yet everything I ate in Central PA tasted like… nothing. Just textured water. Boiled food, apparently, was considered “cooked.” If it had been during the COVID era, I might have thought I’d lost my sense of taste.

Then one day, I went out to eat with a friend from the area. As soon as our food arrived, I picked up my fork. She picked up the salt shaker.

I was stunned. I had never in my life used a salt shaker at a restaurant. In my upbringing, salt and pepper shakers were decorative—little markers to distinguish a dining table from a nightstand. If someone actually used them, it was either a joke or an insult to the cook. But for my friend, this was completely normal. She wasn’t fixing bad food—she was salting to taste.

This moment stuck with me. I would later realize, these small cultural habits extend beyond the dinner table—they shape our health in profound ways.

The Link Between Culture and Heart Health

We know sodium intake is linked to several health outcomes, especially heart disease. So what happens when an entire region adds salt at every meal over a lifetime?

Looking at geographical trends in cardiovascular mortality, parts of Pennsylvania rank among the highest in the nation for deaths due to heart disease. Meanwhile, Miami-Dade County—where I grew up, and where salt-shaming is a real thing—ranks among the lowest in the country for mortality from major cardiovascular diseases.

Does this mean Central PA’s salt-to-taste habit is a direct cause of higher heart disease rates? Not necessarily. Heart health is shaped by more than just nutrition—genetics, exercise, access to care, and social determinants all play a role. In fact, Miami-Dade does poorly in other areas, ranking among the worst in the nation for cardiomyopathy and myocarditis-related deaths.

But here’s the takeaway: local health trends are deeply tied to local cultures. And that means health systems must do more than push generic heart health campaigns—they need to respond to the specific needs of the communities they serve.

What Health Systems Can Learn

February is Heart Health Month, and many health systems are engaging in broad awareness campaigns—#WearRedDay, educational flyers, and social media outreach. But the real question is: Are these efforts tailored to the communities they serve?

If a community has high rates of hypertension, are health systems addressing sodium intake in culturally relevant ways?
If genetics and obesity play a larger role in a region’s heart disease rates, are screenings and lifestyle interventions prioritized?
Could a hospital-sponsored 5K or heart walk be more impactful than another awareness flyer?

All of these are good ideas for any hospital or health care system. But the better idea is to go with what will best serve your patients. The best approach isn’t just to educate—it’s to listen, analyze, and act on local data. Just like my salt-shaker moment taught me to recognize cultural habits that I’d never considered, health systems need to do the same with the populations they serve. Because at the end of the day, a pinch of salt might seem small—but over a lifetime, it can make all the difference.

February 7, 2025 gsilvera Healthcare

Patient-Focused Transformation

Patient-Focused Transformation: A New Era in Healthcare

In today’s rapidly evolving healthcare landscape, transformation is a necessity. Change is happening constantly in health care, new regulations, advancing technology, global pandemics, workforce challenges, its always coming and always changing. But one thing should never change and should remain at the heart of this transformation for all health care organizations – patients. The way for organizations to sustain and grow through the rapid and recurring shifts in the health care landscape is engaging in Patient-Focused Transformation.

What is Patient-Focused Transformation?

Patient-Focused Transformation is more than just putting patients at the center of care. It’s about building an entire health care ecosystem that revolves around the needs, values, and voices of the individuals receiving care. This approach ensures that health care organizations are not just providing services, but truly partnering with patients to deliver solutions that are innovative, inclusive, and impactful.

Why It Matters

Health care systems are facing unprecedented challenges—rising costs, fragmented care, and disparities in access and outcomes. Yet, amid these challenges, a clear opportunity exists: by prioritizing patients in every decision, healthcare organizations can foster systems that are more effective, compassionate, and equitable.

At its core, Patient-Focused Transformation is about empowering patients and healthcare professionals alike to engage in a more collaborative, supportive environment. It encourages the integration of technology, innovative practices, and patient feedback to build health care systems that prioritize quality, accessibility, and patient satisfaction.

The Impact of Patient-Focused Transformation

When health care organizations embrace Patient-Focused Transformation, the benefits extend beyond improved patient satisfaction. This approach leads to:

Improved Health Outcomes: With patients actively engaged in their care journey, outcomes improve as treatment plans become more personalized and aligned with individual needs.
Greater Inclusivity: Patient-centric systems ensure that all voices are heard, particularly those from marginalized and underserved communities, creating a more equitable healthcare environment.
Enhanced Innovation: When the focus shifts to solving real patient problems, healthcare organizations are better equipped to develop cutting-edge solutions that drive continuous improvement.
Operational Efficiency: By aligning systems and processes around the patient, organizations can streamline operations, reduce waste, and optimize resources.

How We Drive Change

Welcome to the journey. Here, we are committed to guiding health care organizations through the journey of Patient-Focused Transformation. Through innovative strategies, inclusive practices, and a patient-first approach, we work with our clients to create lasting impact and positive change in their healthcare delivery models.

If you also believe the future of healthcare is one where patients are partners in their own care—where their needs drive every decision, and where organizations are continuously evolving to meet those needs, then you are in the right place.

Conclusion

By focusing on the patient, we can build systems that are more compassionate, more effective, and more equitable. Contact us to see how we can help you shift to Patient-Focused Transformation.