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3rd Conversation (3C)™ Frequently Asked Questions

What is 3rd Conversation (3C)?

Health care today is tough on patients and clinicians. Many feel powerless, frustrated, and angered by our broken system. Clinicians are burning out and leaving practice at alarming rates; depression and suicide are on the rise. Patients often feel left alone to fend for themselves in a complex system. Right now, patients and clinicians are talking about their respective experiences in separate conversations. We think it's time for a new conversation – a 3rd conversation – that brings us together to connect as humans and explore how reinventing the patient-clinician relationship can be a source of power, healing, and fulfillment. 3C is designed to bring this new conversation—and the remarkable changes that it brings about—into reality.


What is the 3rd Conversation (3C) approach?

Now in its second year (Phase II), the 3rd Conversation creates space and freedom for patients and health professionals to connect in a new way and a new context that builds empathy and a deep appreciation for each other's core humanity. It helps reinvent the clinician-patient relationship, driven by those who know best: patients and their clinicians (or “care teams”). The experience is designed to boost both clinician and patient wellbeing. They leave the room feeling enlightened, inspired, motivated, and supported to continue the conversation and to turn that conversation into action.


What is the goal of 3rd Conversation?

Simply stated, the goal of 3rd Conversation is to test the potential for 3C to generate deeper and sustained human connection and focused systems change.


What is the vision of 3rd Conversation?

The social fabric of healthcare is torn. The threads of human connection stand alone and disconnected now because of the way the system is organized and financed. The 3rd Conversation is re-weaving healthy, empathetic human connection in a way that helps people see their common desires and interests in healthcare. The horizontal threads are the clinician-patient relationship dyad. The vertical threads are where we weave system leaders/decision makers back into the fabric in a human-connected way. All this to create a beautiful tapestry borne out of human connection which heals more deeply and completely than ever before.


What’s in it for those who participate in 3rd Conversation?

The benefits to participating organizations are multi-fold.Many are struggling to address rising rates of provider burnout, depression, and suicide.While not a panacea, 3C reconnects providers to meaning in their work and the reason they went into healthcare in the first place. It offers an opportunity for providers and patients to describe a shared vision of the healthcare system they collectively desire, and to take action to bring that future into reality.


In addition, 3rd Conversation also adds an entirely new dimension to efforts to develop a patient-centered culture. It complements initiatives such as Patient Advisory Councils, taking organizations to higher levels in their work to create the healthcare system that patients (and providers) deserve.


For organizations striving to develop their capacity for innovation, 3rd Conversation is an excellent opportunity to practice testing cutting-edge ideas, building skills in incorporating fresh and “counter-cultural” ideas, and learning to co-create with patients.


Where were the Pilot sites of Phase I of the 3rd Conversation?

Phase I of 3C was piloted in Camden, NJ; Atlanta, GA; Boston, MA; Lehigh Valley, PA.  [Should we name the places specifically?] The results were very positive and many of the participants wanted to continue beyond the Spark Event because of the connections that had been forged and the momentum generated by the unique and impactful experience.


What is a 3C Phase II Innovation Site?

A 3C Innovation site is a primary care practice/clinic/community health center or similar setting, engaged in long-term relationships with their patients, that has been selected by the 3rd Conversation National Team to join 9 other organizations as Phase II participating Innovation Sites.


What are the qualifications that 3C National team is looking for in prospective 3rd Conversation Innovation Sites?

The 3C National Team is looking for deeply committed people who will fully deploying the 3C through a 4 – 9 month process, designed to build empathy and generate momentum toward culture and system change. This involves hosting “Spark” event(s) (a three-hour, facilitated event where clinicians and patients break bread and sit knee-to-knee); sharing the stores that emerge; and engaging with the group in an online community, led by the site, but using resources provided by the 3C Team.


Innovation sites will help co-develop what comes after the initial Spark phase to create and sustain longer term changes in local communities of care, aligned with local priorities.The success of a 3rd Conversation project in an organization relies on the consistent engagement of an energetic, respected, and engaged lead/host who is excited about innovating to address burnout and connect and collaborate with patients, family caregivers, and fellow clinicians


Is there a fee to become a 3C Innovation Site?

There is no fee required to become a 3C Innovation Site.However, Innovation Sites provide site leadership, project management, and the resources necessary to complete the required tasks on time to ensure success of their initiative.


How long does a full 3C initiative take from initiation to completion?

The goal is for 3C to catalyze something that continues far into the future as each site develops its unique approaching to sustaining and deepening what 3C began.  In terms of the formal work in partnership with the 3C national project team, the time to completion varies according to site and how each chooses to further the outcomes and momentum of the Spark Event.   The partnership can range from just a few months to as many as 9 months of structured, collaborative work.


How can my organization become a 3C Innovation Site candidate to considered for inclusion in Phase II?

Contact Laura Adams, Catalyst at X4 Health at or 781-608-8473.


Can any organization become a 3C Innovation Site?

Unfortunately, there are a limited number of slots available. There is a selection process, as not all interested organizations can be included as a full-fledged 3C Innovation Site.  However, there are ways in which the interested but not selected sites can engage in and benefit from the 3C initiative. 


What is a Spark Event?

A Spark Event, which takes place in the evening, brings local patients and health professionals together, to break bread and create the conditions for conversations about:

  • What health care looks like when it works, such as the best experience they ever had with a patient or a provider and why

  • How the health care system would look if the patient-provider relationship was in fact valued and served as the primary design principle

  • What needs to happen for that vision to become reality

  • What patients and clinicians can do together – next week, next month and next year – to achieve that reality


Spark Events are designed to have a transformative effect on attendees, so that afterward, they “show up differently” in their lives and in their relationships with others.


What happens after a Spark Event?

Stories with be shared with a “Stories to Systems Change” intention and with the goal of facilitating the very powerful stories that emerge from the Spark Event to “go viral”.It’s all about changing the conversation and spreading the change as far as possible by inspiring others to join in.


Some sites will want to go deeper with their systems change intentions and may have an opportunity to work in a closer relationship with the 3rd Conversation National Team to further their efforts.


How many people do you need to hold a Spark Event?

The ideal number of participants in a Spark Event is 12 – 20 patients and 12 -20 providers.It’s important to match the number of patients attendees with provider attendees, so that each patient participant can be paired with a provider participant.


How long do Spark Events last?

Spark Events last 3 hours – from 5:00 PM to 8:00 PM (including dinner).


Do the patients invited to a Spark Event need to be patients of the providers that are invited to the Spark Event?

While it’s helpful if the patients participating in the Spark Events are patients of the Innovation Site/practice, they do not have to be patients of the specific providers attending the event.


Are only physician providers allowed to participate in Spark Events?

While strongly encourage an Innovation Site to have a robust complement of physicians in attendance, other members of the care team are also welcomed participants.


What is expected of Innovation Sites?

X4’s role isn’t to do the intervening for your organization. We help you to re-weave the social fabric in meaningful ways to equip you to do this on your own in human-centered, relational and deeply healing ways.  Practically speaking, the expectations of Innovation Sites are to:

  • Help co-create a successful 3C learning and innovation cycle with the 3C National Team.

  • Secure institutional leadership buy-in and/or have authority to allocate some resources to this work, primarily staff time.

  • Formulate a robust local team with the roles outlined in the Program Design document.

  • Help the 3C National Team evaluate events using the evaluation tools provided by the 3C Team.

  • Maintain ongoing engagement/communication with the 3C National Team (e.g., by joining bimonthly calls and training opportunities)

  • Provide an on-site logistics lead for planning purposes. We’ll provide an event planner for you.

  • Recruit a diverse group of a total of 12-20 local clinicians and 12 -20 patients to be paired up for each Spark event

  • Give the 3C National Team feedback on other tools we’re developing, like a facilitator’s guide and meeting planning toolbox.

  • Be part of an online community to continue the virtual 3rd Conversation.


What kind of help and support does X4 Health provide?

3rd Conversation innovation sites are not alone in this work. They receive extensive, tailored support and technical assistance from the national 3C Team, comprising project managers and event planners as well as experts in community engagement, coalition-building, storytelling, patient and family engagement, and facilitation, among other things. 


The 3C National Team, thanks to the generous support of the Morris-Singer Foundation, also provides a stipend for innovation sites to support this work. Additional benefits include:

  • A site coach who will work with the site through the entire process and provide strategic and tactical help, training, coaching, and coordination.

  • A facilitator, or in some cases, facilitator training and the facilitation guide.

  • An event planner, or for more experienced sites, an event planning toolkit.

  • Storytelling coaching, tools, and feedback.

  • A post-event evaluation survey and incentives for completion ($25 gift card) to ensure high response rates.

  • A template to capture and share event pictures, quotes, outputs – with support from the X4 team to complete it as needed.

  • Access to a private online group within the national 3C Mighty Networks online community.

  • Access to a training/tools library with resources on narrative leadership, appreciative inquiry, group process, online community building, and other topics that emerge as essential to success.

  • A $5,000 stipend to be used however the site determines.


Does an Innovation Site need to have experience in bringing patients and providers together?

It is strongly preferred that an Innovation Site has experience in bringing patients and providers together. The ability to secure patient and provider participants is central to the success of 3C at any given site, so proven capability is extremely important.


Is it okay to have observers attend a Spark Event?

The conversations that take place at a Spark event are often characterized by vulnerability, openness, “heart-to-heart” exchanges.In order to create the conditions for this type of human connection to occur, the number of observers is kept to a minimum.


Who funds the 3rd Conversation initiative?

The Morris-Singer Foundation has funded both Phase I (2018 – 2019) and Phase II (2019 -2021) of the 3rd Conversation initiative.