I don't have the answers but I can stand next to you while you figure it out. Our healthcare system is a mess. Many of the stakeholders are working in environments that are toxic. Collaborative teams are not evolving in a way that aligns with the digital economy. Look to the days of Steve Jobs--he hired opera singers, dancers, and IT specialists for sure but he looked for passion and skills--not an algorithm. The current selection process is based on a factory model of how we define experts and talent. You need to go to the right university, get the right degree, buy the right house, live near the right company, and most importantly conform, conform, conform. Entire economic models depend on your tuition, mortgage, bank fees, 401k fees--and willingness to be the same.
It is difficult to get a man to understand something, when his salary depends on his not understanding it.--Upton Sinclair
I personally don't believe we have time to wait for the full transition--and there will be one. Let me explain. I was recently sitting in an advisory council meeting sponsored by a pharmaceutical company. There were physicians and experts in attendance from the leading academic centers in the country, arguably the world. I have been to dozens of these but this was different. The doctors were pissed. They were challenging the pharmaceutical company researchers and data scientists. Industry endpoints are not created for patient benefit but for corporate profit, your endpoints don't reflect my patients. More than once the data was torn apart and accused of being biased.
I felt guilty. It was that moment that I realized I was part of the problem, the free-market well-oiled machine of medicine. My writing skills, pharmaceutical experience, knowledge of clinical medicine, statistics, economics, did not need to be packaged and commercialized to benefit healthcare. I could actually choose to be different. It was time for me to do the risky thing, probably well past the time.
It is a broken system and I want something different. I no longer write words that aren't informed by data or write for profit-driven organizations that benefit from escalating healthcare costs. If you create value, you will be in demand. I speak to groups about our changing economy and how this influences healthcare,, I have been invited to report from the Whitehouse, and I write about policy, health, and economics without an outside influence. I read the latest books in the industry, I choose to do what is right--in front of me. If you want better answers, ask better questions.
We make new decisions based on new data. Culture changes. It has to, because new humans and new situations present new decisions to us on a regular basis. Technology amplifies the ever-changing nature of culture, and the only way this change can happen is when people decide that a permanent rule, something that would never, ever change, has to change. And then it does.-- Seth Godin
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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!”