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Diseases of the US Political System:  Medical Case Presentations


Using the medical case presentation (MCP) for deliberative dialogue to address the challenges facing the United States 


The Liberty Bell

The Liberty Bell is an iconic symbol of  American independence, located in Philadelphia,   Pennsylvania.  In its early years, theLiberty Bell was used to summon lawmakers to legislative sessions and to alert citizens to public meetings and proclamations. 


Clay Shirky, reviews the importance of an organizing framework for change and a way for people of different ideas to interact to achieve improved outcomes. 


The medical case presentation is an essential framework for a focused disciplined approach to addressing medical problems. Healthcare professionals use the MCP to identify, analyze, develop, implement and monitor a solution based “treatment plan” for medical problems (including biological, psychological, social and spiritual factors). When used effectively, it allows healthcare professionals to communicate and share information among varied clinical disciplines to develop testable hypotheses for simple and complex problems. The framework allows for clearly identifying problems and providing objective data to support the diagnosis and “treatment plan.”


The medical case presentation is uniquely positioned to put the citizen back into the We the People. The initiatives help address systematic changes over time. Through progress notes addressing specific problems, we’ll be able to adapt to new issues to clearly identify problems and potential solutions. The disease metaphor in general and the cancer metaphor in particular have been used throughout American history to highlight dangers of particular aspects of American life.


The MCP is a collaborative process consisting of the following:


1. Define the problem

2. Provide the relevant data needed for a rational discussion

3. Discuss the various options, barriers and their consequences

4. Formulate a treatment (action) plan based on measurable outcomes, transparency, accountability, informed consent

5. Carry out the treatment plan and,

6. Monitor outcomes and update the action plan.


We use the structure and process of the medical case presentation (MCP) as a framework for deliberative dialogue to address civic challenges.


The Pain Opioid Epidemic

The Case of the Frustrated Citizen

The Case of the United States 1787

The Cancer of the US Political System

The Case of the US Healthcare System

The Case of the VA



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