Naively, when I began advocacy twenty years ago, I envisioned a cycle of quality improvement where things only got better. I never imagined a future where ER wait times, patient safety, experience, respect for caregivers, staff morale and patient engagement got so much worse. But here we are.
Lately, I've been in the phase of my career where I’m struggling with my work as a health care advocate. I think, “What’s the point?” as our health care system collapses into rubble.
I’ve written an entire book rooted in the Serenity Prayer for health care change-makers:
…grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.
What is in my control? Certainly not influencing the Health Minister at the policy level in Canada’s highly politicized health system.
So, what could I change? I certainly could surround myself with other health advocates who are struggling like me. We could support each other with information sharing and shoulders to lean on.
In 2022, the idea of Give a Duck, an online community for health advocates, was born. Twitter had been my supportive place until it became an unsafe platform when Musk took the reins. I thought others needed that Twitter alternative too – and that was my first mistake.
Give a Duck lived for one year and then I shut it down in November 2023. This is the tale of its short life.
I’m purposely avoiding the word failure when I talk about Give a Duck. Creating something out of the depths of my heart and it doesn’t fly is painful. But I also talk to health care audiences about trying something new. There’s always a risk that it won’t work. But success (in a strange way) can come when you try anyhow, despite the risk. Maybe success comes from growing and learning, not from accolades and numbers.
My own company Bird Comm sponsored the costs of Give a Duck. It was custom-built on the Mighty Network platform, with graphic and IT support from our own staff. We did the right things: tested it by engaging three health advocates, tweaked it based on their feedback, promoted it when we launched it, filled it with a library of all the references from my books, and warmly welcomed everybody who joined.
We offered a free membership, no questions asked, and there were other levels of membership for those who wanted to support Give a Duck financially. Mighty Networks is not cheap! And we of course paid folks who worked on it, so there was a significant cost to running the platform. In the end, the subscription base couldn’t cover the costs, which was one of the reasons for its demise.
Early on, another health advocate who had built a similar platform told me that they, too, had all the content. But no matter what they did, they couldn’t encourage members to post and it was eventually left to languish. This stung when he told me this, but you know what? This is what ultimately happened to Give a Duck too.
I want to acknowledge the 100+ people who did join Give a Duck. Thank you for giving it a go, for posting, for sharing information, for backing the concept financially with your memberships. I hope you felt supported, picked up useful information and created new connections these past 12 months. I’m grateful to you for taking a chance on Give a Duck.
When you try something new and stumble, you first must tend to your wounds before you can reflect on what went wrong. Then you can get up again.
I’ve spent the past two months thinking about Give a Duck. Here are my lessons.
Just because I need an online space for support, it doesn’t mean others do too. Lesson: Survey your potential audience thoroughly by asking the right questions. Yes, I had spoken to other health advocates who were interested in the concept, but that interest had not transformed into participation.
Instead of building a new platform, consider going simply where the people already are. This was a big lesson and ironically, something we tell our health comm clients! If I had created, say, a Facebook group, on an existing platform where people already regularly go, I might have had more success.
Online habits are hard to adjust. I know this from my many memberships on Patreon and Slack – sites that I forget to visit unless I get reminders in my inbox. I’m on LinkedIn and Instagram every day. Changing my own online habits to visit a new site is nearly impossible for me. I should not have assumed it would be easy for the Give a Duck members either.
I felt disheartened when my own regular posts and live events didn’t get much uptake. I should have been satisfied with the handful of folks who did participate, but instead focused on the dozens who did not. I broke my own cardinal rule, which is: Love the ones you are with.
A positive! Mighty Networks is a great platform for community, but I’d use it for a community that is already built, not for creating a new one. For instance, we have clients who are regulatory colleges, where members have to go online for registration and continuing professional competence. I can see Mighty Networks serving a useful purpose as a space to complement an existing website that is already being used.
I found out how my work with Bird Comm in creative health communications was totally intertwined with my work as a health advocate. In advocacy, I often preach about respect, dignity, information sharing and partnership with patients. Give a Duck offered many online digital platform lessons about engagement and promotion that I could bring into my work.
I still need support as I continue swimming against the tide in health care. I know from my interactions on Give a Duck that other folks do too. So instead of an online space, I've been making the time to meet up with health advocates in person – for coffee or lunch – close to home, or far away when I’m travelling. These in-person meetings have been heartening.
Meeting advocates in different health advocate worlds, like eating disorders and long-term care, inspired me to learn about new communities so I can grow and learn. Starting this month, I've joined networks of health care advocates that already exist. I’m learning about patient safety and medication through the Canadian Medication Safety Network and the immunocompromised community through the Canadian Immunocompromised Advocacy Network.
The Internet is full of success stories. Alas, real-life has more defeats than wins. It feels crappy to talk about when you’ve fallen. But if we are to be authentic with each other, we have to talk about things that aren’t Instagram-worthy – the times we struggle, we try, we fail. I write this essay not to look for pity, but to be real.
One positive about speaking openly about my health advocate moral distress is that others have stepped up to create new spaces for conversation, like Lisa Machado’s writing in Healthing that advocates for the advocates and Rae Marten’s initiatives to raise up people with lived experience. I will join them as an enthusiastic participant.
In the end, Give a Duck taught me to try something new again, even knowing I will likely fail. I must make space for that failure because it will sting. I should try not to get stuck in it and give myself grace and lick my wounds. Repeat, repeat, repeat, repeat.