Enabling Error: Med students, mistakes, and modernization

Why does health care seem to lag behind other industries in innovation? There's a temptation to manufacture reasons that don't necessarily explain why health care has not seen the kinds of revolutionary changes evident in industries from computing and telecommunications to music and retail? People routinely marvel at how easy it is to manage their bank account these days, but they don't appreciate continuing to wait hours in their doctors' offices, repeatedly filling out patient information forms, and fighting to get a satisfactory amount of quality time with their doctor.

The knee-jerk temptation is to hurl blame at doctors' conservative outlook, the industrial medical complex, or just frank stupidity. I think these judgments are misguided.

Breaking the Cycle: Does the hamster wheel blind docs to social media?

Ten years on, Ian Morrison’s “Hamster Health Care: Time to Stop Running Faster and Redesign Health Care” is still eminently applicable. In his words:

Across the globe doctors are miserable because they feel like hamsters on a treadmill. They must run faster just to stand still. In … the managed care systems in the United States doctors feel that they have to see more patients to maintain their incomes. But systems that depend on everybody running faster are not sustainable. The answer must be to redesign health care.

Leslie Saxon says it best.

This talk, Body Computing and Networked Communications, is an excellent glance at the future of medical technology.



Leslie Saxon, M.D., @DrLeslieSaxon, is a Professor of clinical medicine at the USC Keck School of Medicine, specializing in the diagnosis and treatment of arrhythmias in patients with congestive heart failure.

This talk was delivered at TEDxUSC in August 2010.

5 Rules for Medical Students to "Tweak" the system

Many fellow medical students are eager to improve "the system." However, an overeager attitude offers both promise and peril— promise that budding physicians are inspired to improve the inner workings of their chosen field, peril in that our naiveté may simply clutter the very complexities we seek to improve.

How do we strike a balance between getting involved and getting in the way?

I found guidance in law professors Raustiala’s and Sprigman’s post on the New York Times Freakonomics blog: "Tweakers and Pioneers in the World of Innovation":

Some innovators create radically new ideas.  These people — the Thomas Edisons of the world — are the kind that we most commonly associate with innovation.  Let’s call them “Pioneers.”

But the Pioneers aren’t alone.  There are many innovators who improve ideas by refining what others have done.  We call these “Tweakers.”  Tweakers don’t get as much attention as Pioneers.

What precisely is meant by medicine "going digital"?

We have an intuitive sense of what is meant by those urging medicine to "go digital." It seems to refer to modernizing, becoming more flexible, and basically following the path of modern computing and information technology.

Is it useful to think more rigorously than this hazy conception, without necessarily reading a special report from The Economist (excellent though it may be)?

Digital information is special because it can be transmitted to and instantiated within any number of devices that are now cheap and portable. The information is can be located at several places at once, and can travel instantly and cheaply. Lord Harold Samuel was talking about more than property when he said "The three things that matter in property: Location, location, location."

The Adjacent Possible

The title of this blog is inspired by Steven Johnson's Where Good Ideas Come From: The Natural History of Innovation In it, he describes Stuart Kauffman's concept of the adjacent possible. The concept represents all of the potential next steps that innovation could bring us to.

An example would be Apple computer's sale of cheap personal computers. Making inexpensive machines available to the masses vastly expanded the ability to explore the potential of computing in ways that massive mainframes, with their select group of highly trained experts, never could approach. Thousands of tinkerers and hackers eventually disrupted the mainframe industry because the innovative potential of many PC's, though inferior to the mainframes' capability, simply exploded throughout the adjacent possible.