The Ugly Pearl of Healthcare

The world is your oyster.

A grain of sand. A biological process. Time.

A pearl.

The story of the pearl and the oyster is one of the most powerful mythologies.

…But what if we twist the metaphor a bit? What if the process that takes a tiny germinal and then grows around it something terrible?

In thinking about today’s Healthcare – all the Kafka moments, the waits, the language, the disconnects, the rules that self-defeat – it’s obvious that we need to understand what happened.

The problem is: we can’t really. We don’t have time to do a deep analysis. But metaphors can help us gain perspective.

So, I offer the Ugly Pearl.

A pearl, like health care, is supposed to be fascinating – in a cool way, ya know? Well an ugly pearl…well, that’s just heartbreaking.

So here we go…

There were grains of sand around which modern healthcare formed:

  • Military context – “Doctor’s Orders
  • Paternal social structures
  • The factory, assembly-line mentality of the Industrial Age
  • The objectification of the patient

These were some of the grains of sand around which grew an important part of civilization.

Over time – more than a century – these grains of sand have accumulated, infiltrated and calcified around healthcare.

And all this ugly pearling has produced lock-in: once a traditional idea sinks in, it’s hard to remove it.

For example: there was a time, not very long ago, when doctors and nurses determined your pain level. Think of that! It sounds dumb and it is dumb – and yet, there it was: a locked-in dumb idea which took wrenching to remove.


Hospitals still run on the factory-model.

There are physicians who still don’t listen to their patients – truly listen.

Nurses are still often abused – and abuse each other – in a manner that recalls the woman-hating cultures of the past. (It may be more subtle today, but it’s there – and it affects the males in the profession too.)

Patients often still feel like objects – or soldiers on a battlefield waging for the portability of and access to their healthcare data.

What’s more, physicians and nurses and other providers are now in the ever-tightening grip of this ugly pearl.

Today’s Healthcare is not PERRLA, and the industry is largely entrenched in lock-in.

But the world is changing.

Hospitals don’t get to decide if Social Media goes away.

Physicians don’t get to decide what patients do online.

When the world changes, smart people don’t look down at their feet.

When the world changes, smart people ask how it’s changing. They work to understand the world around them.

They entertain the possibility that all their decades of what they know aren’t what they should know.

Their pupils are open, equal, round and react to light and accommodation.

Healthcare – according to the stereotype – is made up of smart people.

If that’s the case, I have no doubt that we’ll witness the formation of a what a pearl should be: an achievement of life.

If it’s not the case, we’ll be ensnared in an ugly pearl for a very long time.

The world is your oyster. So is your health.

@PhilBaumann@HealthIsSocialPearls of Wisdom


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