W. Edwards Deming
This is a bread crumb on the path of my discovery of systems thinking. Because I am preparing a dialogue for a continuing medical education conference, Destination: Patient Outcomes. Our Journey to Improving Patient Care I am focused on building new models. Unfortunately, economics doesn't own the paradigm of navel gazing. I think healthcare is a harmful manifestation of many of the ills of out-dated economic theories.
For example, why are we measuring provider "behavior" in multiple choice formats? Slapping a case study at the center--to fix the problem-- is a little like Ptolemy insisting that the earth is the center of the universe. We had to wait years for Copernicus to discover the earth rotates on its own axis and his theory of heliocentrism.
Yes discrete choice experiments and trade-offs are more complicated to measure but then again--survival is not mandatory. Eventually these old models will be obsolete when enough evolved thinkers start asking better questions and questioning the fraying answers. A recent podcast from the London School of Economics discusses how modern models in economics should be thought of as a doughnut where social foundations are bound by the ecological limits of the planet. How we think of capitalistic growth and where the limits should be defined is pertinent to spiraling healthcare costs and the GDP that is falsely expected to save out-dated economic theories.
I get frustrated when pundits or "game-changers" discuss technology growth and economic power of industries as solutions. The reasons for paying the price of the latest in "innovative" solutions ignore our crumbling social foundation upstream from disease. Those with the microphone cite the danger of stifled innovation--but what if growth for growth's sake destroys our communities?
Personally I think we all need the systems thinker approach. Sprinkling words like patient-centric, shared decision making, patient-reported outcomes in an economy that is unsustainable and lacks regenerative and distributive economic principles is not the answer for humanity. It is the answer to your growth and profit driven business model.
How can we turn economies that need to grow, whether or not they make us thrive, into economies that make us thrive, whether or not they grow?
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Thank you for making a donution!
In a world of "evidence-based" medicine I am a bigger fan of practice-based evidence.
Remember the quote by Upton Sinclair...
“It is difficult to get a man to understand something, when his salary depends upon his not understanding it!”
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