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Keywords: Participatory medicine, health care quality, communication, patient engagement, SPM.
Citation: Greene A. The Participatory Seal. J Participat Med. 2012 Nov 21; 4:e29.
Published: November 21, 2012.
Competing Interests: The author has declared that no competing interests exist.

What would it be like if patients could identify participatory physicians as easily as they could use Yelp to identify a restaurant serving their favorite style of food? This kernel of an idea gave rise to the SPM Seal Program with a more ambitious goal — to not just identify Participatory Medicine, but to help create a culture of participation in medicine.

We modeled the Seal Program after the successful WhiteOut Now campaign, which distilled pediatric nutrition advances into a very few simple, powerful, achievable actions that could help change the trajectory of children’s nutrition: “End white rice cereal for babies.” “Let every child’s first grain be a whole grain — they won’t mind, they’ll than you.” “Let every child’s first food be a real food.” These ideas spread quickly, and the landscape of infant nutrition became very different in just a year.

The first task of the team of volunteers working on the Seal Program was to distill the idea of Participatory Medicine into a very few core commitments that could be used both to identify people engaged in Participatory Medicine and to instigate change by creating feedback loops and patterns of participation.

We ran the initial ideas past many patients and physicians, singly and in groups, starting with all of the attendees of the Patients 2.0 Conference in 2010. Feedback from the crowd adjusted and whittled the ideas over time, sharpening them into demonstrating mutual respect through 4 commitments: shared data, shared feedback, shared resources, and shared decisions.

Patients can nominate any physician (or other clinician with an NPI number, such as many nurse practitioners and psychologists) who can obtain the Seal by committing to (1) proactively giving people access to their medical data (I’ll call if the lab result is abnormal is no longer sufficient), (2) encouraging feedback (including anonymous feedback), (3) providing tools and resources to help manage health between visits, and (4) encouraging their patients to participate in their own health decisions. They can use the Seal on their websites and web profiles, as well as in their offices.

Likewise, patients (and physicians – they are patients too) can obtain the Participatory Patient Seal by committing to (1) accessing your health data (knowing your numbers), (2) giving feedback to all your clinicians (perhaps the most transformative piece of this program), (3) using tools and resources to manage their own health between doctor visits, and (4) encouraging their clinicians to be participatory providers.

The initial goal is to have 10,000 physicians with Seal. But reaching this goal will start with patients. Go to Take the pledge yourself. Nominate the participatory physicians and other clinicians you know. Help change the culture of medicine.


Much thanks to all those who have worked on the Seal, especially Alan Viars, Elise Singer, Indu Subaiya, Fred Trotter, John Grohol, Marcus Thygesson, Mark Scrimshire, and Richard Sacks.