The time has come to try to get in trouble. Just a little bit. By all means, go on collecting your data and hitting your targets, but stop keeping your head down all the time. Be a badass and try something new. Use whatever leeway you’ve got to do small things that are different and bold and a little risky. Build some credibility with your little wins. Then go a bit bigger with it. Why? Tired, mediocre
junk bullshit doesn’t change anything. You do want to change things, don’t you? Otherwise you’d probably be reading a paper newsletter called Status Quo Public Health, written in Microsoft Works.
Of course, the system isn’t set up as a friend of innovation. Federal, state, and local governments are set up to favor existing providers and previously funded programs. Public grants come with hefty reporting requirements, and tend to go toward evidence-based interventions – even if they’re based on small studies from twenty years ago. Foundation grants come with their own restrictions and motivations. This means that we all wind up spending a lot of time just trying to function within some pretty inflexible parameters. But my point stands: You have to find a way to do some things differently from your peers. You have to be willing to be risky. It’s the only thing that will keep you competitive as the funding continues to melt away.
Right now, you might be thinking about how you don’t have time or resources to waste on things that might not work. I hear you. But listen: there is waste, and then there is risk. Somewhere along the line, we started to mix them up, but they’re not the same thing at all. Waste is often dressed up as “but that’s the way we’ve always done it.” Waste is neutral colors, safe language, and talking about the weather. Risk, on the other hand, is loud and boisterous. Risk is probably wearing a big, crazy hat and cracking sex jokes. You might love it or you might hate it, but it definitely makes an impression. Waste fades into the background. Risk stands up and gets noticed. Waste is safe. Risk isn’t. Waste gets you nowhere. Risk might get you somewhere.
We happen to be pretty comfortable with waste in public programs. We are way less comfortable with risk. This a problem for most humans, but it’s a problem that public health can no longer afford to have. It’s impacting our ability to do our jobs well in an environment where we’re increasingly competing for attention. What are you so afraid of, anyway? That your little program will get called out on a national level like those Obamacare keg stand ads from Colorado? You should be so lucky.*
Here’s the thing. I can promise you that someone will always think that you are wasting money. It’s a natural consequence of almost everyone having to pay taxes, whether they like it or not. If you are trying to please everyone, then you are serving no one. This is an idea that is accepted by smart businesspeople, but foreign to the public sector. Trust me – if no one is complaining about your program, then no one knows you’re there. (If you don’t believe me, go to a public meeting on something. Anything.) We can’t serve every person with every dollar that we spend. So stop trying.
Instead, try to serve a smaller number of people really well. You can do that by thinking about the people you’ve had a positive impact on already, and figure out what they need. (Here’s a hint: it might not be what they think it is. They might say they need a meal, but what they might really need is both a meal and to know that someone cares enough about them to give them a meal.) What could you do that they wouldn’t be able to shut up about? How can you do something just crazy enough to get noticed, but not so nuts that you lose your funding? Figure those things out, and then do them. Build something different. If it works, the funding will follow. Oh, and you might really help some people along the way.
TL;DR: Take a damn risk already.
And then do it again.*For the record, I’m not a huge fan of those ads. That being said, I’m not their target audience so my opinion doesn’t mean jack. Plus, I appreciate the ballsy approach. Props to the Colorado Consumer Health Initiative and ProgressNow Colorado for getting people talking nationwide with practically no budget.