Meta-Kucha: the margin or the mainstream?

The inexorable push in integrated care is to move collaboration between biomedical and psychosocial clinicians into the mainstream of health care. This effort requires expanding small models to scale, convening statewide transformation initiatives, and leaving the comfortable confines of safety net clinics to prove integration in the for-profit systems that dominate American health care. CFHA's (Collaborative Family Health care Association's) Pecha Kucha Plenary assembled compelling narratives from the fringes of our health care system. The competing calls from the mainstream and from the margins force tension into our dialogue. However, for our model to be widely embraced, we need blueprints that fit most patients in most clinics. What we learned from the Pecha Kucha narratives is that people at the margins find ways of asserting their voices and achieving their needs. Sometimes it is through their own resilience and disruptiveness; other times it is through an advocate from the mainstream who shares their stories in such a compelling way that they bypass our well-crafted models and spark our souls.