Health 2.1

There are one too many edges.

I apologize if my thoughts seem scattered and random, but that is how my mind operates sometimes, especially when surfing the net. So bear with me. Perhaps my thinking and philosophies will crystallize as I write. Then again, fluidity is likely preferable in many ways. I've always maintained that my greatest strength as a clinician (perhaps my only strength?) is my willingness to adapt and change in light of better information. Too often, I think, people's attitudes and actions solidify into unbreakable habits. Change is, I suppose, frightening, but it is also very exhilirating. For instance, I constantly try to have my clients open themselves to the possibility of exploring new ways of moving. This requires letting go and that can be difficult. Like Come to the Edge:

"Come to the edge.
We might fall.

Come to the edge.
It's too high!

Come to the edge.
And they came,

and we pushed,
And they flew."


Christopher Logue


In a post a couple of months ago, Esther Dyson discusses a panel of health care experts. "They explained the problems with the system eloquently: mis-aligned incentives, stalled information flows, undereducated consumers, overworked doctors, prohibitive liability insurance and excessive CYA testing, and on and on. It was clear nothing could be done."
She goes on to comment that, "If this session had been held in my industry, I thought, there would have been five ex-doctors with perpetual-motion-like schemes to predict the onset of cancer, realign incentives, re-train consumers and avoid the extra testing through better information management. And there would have been ten VCs waiting to fund them. Where was the energy, naivete - and funding - that could foster change?"
This is fascinating writing for me. Where are the solutions? It is so interesting to see different worlds colliding. The idea of venture capitalists in health care may seem foreign or perhaps repugnant to Canadians, but the desire for change is no less evident here. We'd mostly agree that "at the center of everything there's a calcified heart pumping blood/information/money in the wrong direction through a tangled mass of arteries that misdirects resources to tumors and useless vestigial organs." Clearly some radical surgery is required. I, for one, think it will require far more than the quest on which my local health authority has embarked. Though I guess seeing people as people is a good start.

How does a doctor's role change when a patient is directing him what to research on Google? Maybe it will not change that much at all. Dyson asks, "much of the conversation centered around getting information to users, but what about getting them to act on it?" That has always been the issue, hasn't it? Again, it is not so much in the knowing as in the doing.

Dyson concludes: "In the end, the cheapest way to foster health is to maintain it, reducing the need for health care in the first place." I couldn't agree more and we better start soon.