Hospitals are examples and metaphors for the iatrogenesis of our entire provision of health care.
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Category: Healthcare Reform
The Coming Catastrophe of Medical and Nursing Education
It’s easy to get wrapped up in the heat, intricacies, and excitement over the politics, economics, and technologies of Health Care (and Healthcare – know the difference).
But you know what? We still need brains and hands to do important work.
It’s important for the right kinds of brains to enter life-long nursing and medical careers.
Right now, however, we are approaching a catastrophe in education – and from two ends: supply and demand. Both the supply of educational resources and the demand of the new generation for serving in Health Care are decreasing.
Today’s physicians don’t feel like they’re doing what they signed up to do.
Today’s nurses don’t feel like they’re doing what they signed up to do.
Each are fighting unnecessary wars with unnecessary people who subjugate the industry with their unnecessary idiocies.
Furthermore, we not only need a new generation of dedicated, educated, and well-trained HCPs, but we also need a new – pardon the expression – industrial complex of how Nursing and Medicine work with each other for the benefit of patients.
I can’t tell you how priceless it was for me to be able to attend an occasional lecture by a physician during nursing school.
But that’s not nearly enough.
Yes, nursing and medicine are different fields – and there are reasons for some of the barriers between them.
But the membranes that separate these professions must be much more osmotic than they ever have been.
Finding ways to better inter-mesh nursing and medical education would produce more educated nurses and physicians. It may be a higher up-front cost to do, but the long-term yields would be well worth the capital.
You can do all sorts of financial reform in Healthcare.
You can do all sorts of things with technologies in Healthcare.
That’s all welcome, of course – if done elegantly.
But none of that will convey Health Care to the places it needs to go if we don’t have a running supply of nurses, physicians, and other HCPs.
Slavoj Zizek wrote a book a few years ago titled “First As Tragedy, Then As Farce”.
You don’t have to agree or disagree with Zizek’s mashup of Hegelian/Lacanian analytics of our Century’s problems.
But, given the state of Healthcare, it’s an apt description of where we’re heading.
Think about that phrase as you reflect on Healthcare today. How many times have you encountered the Farce?
It’s absolutely farcical that there are Hospital CEOs who wouldn’t have the slightest clue about moving a patient from a bed to a chair.
It’s absolutely catastrophic that we are entering crises of shortages of *willing, able, and supported* nurses, physicians, and pharmacists.
I’ll take Zizek’s quirky phrase and advance it forward for Healthcare and what we can expect:
Healthcare: First As Farce, Then As Catastrophe.
How Might Healthcare Utilize Charitable Yield Management?
Click on the image below or here to see the video and my commentary on Rory Sutherland’s TEDxOxford talk on Charitable Yield Management. (Note: This post is partly a test of Pinterest-as-blogging-platform – go ahead: laugh at me for playing around with the shiny-new.)
Source: youtube.com via Health on Pinterest
Depending on how this test goes, I’ll update you how Pinterest might work.
– Phil
Healthcare: Revolt…or Mutate?
As we wind down the first year of the second decade of the twenty first century, Revolution abruptly emerges as a global topic of attention. Clearly, Occupy Wall Street is the social object du jour.
It may be time, however, to think about what Revolution accomplishes. Specifically, what work does it do…and what work does it not do?
If you examine the cannon of Revolution over the last few thousand years, Revolution dominates as a pattern in all civilizations, cultures, religions, sciences, etc.
The work of those revolutions – in retrospect – accomplished the often difficult task of raising awareness. But they rarely – if ever – accomplished the actual lift-work required to manifest the Dream of the Revolution.
No, that work has always been left to another mechanism: the Mutation.
The mutation is what governs the river of biological evolution via natural selection. Evolution is not Revolution: it is Mutation. If Evolution were Revolution, the chromosomal links would break, and species would die off.
It’s those tiny mutations that make just enough of a course-shift, which make giant leaps in function and speciation.
This is the case with Technology and Ideology and Culture – although with a difference: these things do not evolve so much in a Darwinian fashion, but in a more Lamarckian algorithm – the idea for a gun can leap into the idea for a cannon, without having to go through millions of mutations.
Cultural genes – memes – can make leaps, unlike genes. In that sense, the work of cultural and technological and ideological Revolution can take place – but only as the results of accumulated mutations. Leaping ideas (Revolutionary idea) need connected pieces on the ground to accomplish work.
And so it is with Healthcare.
In Healthcare, it’s almost always the case that a slight mutation of an idea leads to radical insights which lead to what we end up calling “revolutionary”.
When the Hungarian physician Ignaz Semmelweis realized that a simple idea – that of hand washing in between deliveries – he generated a slight mutation in conventional medical practice. And although his peers shunned him and continued in their obstinent disregard for hand-washing, his idea became Revolutionary.
That is, Ignaz didn’t do something Revolutionary at the moment of his experiments. He initiated a tiny mutation. And that tiny mutation generated a leap in thinking which changed Healthcare – but even there, his idea isn’t followed sufficiently: to this day, there are doctors and nurses who don’t practice proper hand-washing technique!…
…Which just goes to illustrate how true Revolution almost never happens….just the (hopefully proliferative) expression of “good” mutations.
So what’s my point?
It’s this: When seeking to change an enormous project like Healthcare, you can focus on fomenting Revolution – or seek out the tiny mutations that can spread through vectors already in existence.
This may be a difficult thing to accept for those trying to Occupy Healthcare. Healthcare isn’t a country, nor street, nor any single entity. It is, in fact, the results of millions of mutations.
If you want to Occupy Healthcare, you can’t.
…But: you can take on a few tiny ships on the big ocean so-to-speak.
Everything has an opportunity cost. Might the opportunity cost of trying to create a “Healthcare Revolution” be foregoing the benefit of focusing on making one tiny mutation which could deliver better care – one way or another – much quicker?
A true Revolt doesn’t take place by revolting.
A true Revolt occurs over the course of tiny mutations.
Tiny. Mutate.
Thus the word: Mutiny.
484-362-0451
The Healthcare Hot Seat: What Would You do?
Let’s to a hot game of chess, shall we?
The current needs for health care exceed the financial resources available for them. We call that excess: debt.
The debt has a price. It is called interest. It’s a compound product, this interest.
You’re sick. You get care or you don’t.
Multiply the last sentence by tens of millions.
Multiply the last sentence by debt.
Multiply that last sentence by interest multiplied by 100. Repeat for many years. (Remember, this interest is a compound product.)
Now, for the hot seat. The seat is checkered in black and white. It’s not red, but the heat is just as terrifying.
You have all this capital, as derived from the above.
You can choose to do only one of the following:
- Continue to fund care for the people who are sick now and in the future until the compounding of the product approaches infinity – without substantially changing the fundamental processes of health caring.
- Cut the above funding and use the capital proceeds for life science research, biomedical technologies and other branches of knowledge and sources of ability – and redirect healthcare toward detection, prevention, extension, enhancement and low-cost treatment.
You can only choose one option.
Choose the first and you save millions of lives, and the debt compounds upon itself and the current model of caring for the sick goes on.
Choose the later and millions of lives will likely die or be put into harms way over the next few years – but the interest on the debt reverses, a new kind of health care emerges and, after a painful wait, thousands of millions of lives will likely live well for centuries.
You’re in the hot seat.
It is black and white.
No, you cannot ask for the seat to be warm.
No, you cannot ask for the seat to be gray.
The pawns and rooks and knights are waiting.
What will you do?
Whom do you kill and whom do you bless from the cold command of your burning throne?
484-362-0451
Food Stamps, JP Morgan and the Healthfare State
I’m passing this little fact I stumbled upon concerning food stamps and J.P. Morgan/Chase. I’ll suggest a connection to Health after the fact:
- The largest processor of Electronic Benefit Cards (e.g. for food stamps) is J.P. Morgan. Website for Chase Direct Benefit Card. (Screenshot)
J.P. Morgan received $25 Billion from taxpayers succeeding its acquisition of insolvent Bear Sterns, which Morgan repaid.
Many of us know about the bailout. Few know about J.P. Morgan’s involvement in Food Stamps.
So, to sum up here:
- A banking enterprise which is atithetical to any form of public welfare state – and whose industrial peers’ collective incompetence and sociopathic disregard for their own industry drove many Americans into unemployment and even food subsidies – received capital from the State, hard-earned capital which was forcibly appropriated from the People.
- The same banking enterprise – again: a going concern antithetical to welfare – receives state money to process welfare payments.
These are two important facts to bear in mind with respect to Healthcare.
Regardless of where you are on the political spectrum – from Libertarian to Communism – consistency of belief system is a must.
What J.P. Morgan’s apparent conflict-of-interest demonstrates is the utter lack of moral leadership required to sustain a civilization.
If you are a Capitalist, then you must remain true to the principles of Capitalism.
If you are a Communist, then you must remain true to the principles of Communism.
If you believe in a completely free-market approach to payement reform in Healthcare, then be true to your principles and accept whatever evidence comes your way proving or disproving your stance. And when you die, you must accept the comfort or hell of your deathbed made by the hands of your ideology. Make sure you understand Das Kapital.
If you believe in a regulatory approach to payement reform in Healthcare, then articulate clearly the vision, understand the mechanics of that vision and elucidate the consequences of those mechanisms – for good or ill. And when you die, you must accept the comfort or hell of your deathbed made by the hands of your ideology. Make sure you understand The Wealth of Nations.
Healthcare is about wholeness.
Integrity is the soul of Health. Once it’s gone, it’s gone forever and we die into indignity.
Capital is the most powerful, ramifying and mysterious substance in the world. No civilization has yet figured how to safely handle it.
Capital will the be the frontline in the biggest and most destructive war of the 21st Century. Pick your side and get ready to fight.
I’m with you, whatever side, as long as you hold your integrity all of the way to the heart-breaking end.
