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.

Phil Baumann