Tuesday, April 17, 2012

A Case for Medical Diversity

Diversity trumps ability.

As described by Scott Page in his compelling book The Difference, the thinking is rather straightforward. Good problem solvers in a field are similar, so a collection of them rarely outperforms any one of them by themselves. However, a diverse group of intelligent people is far more effective, so long as they bring difference perspectives and different methods to bear on the problem.

I considered it a powerful argument for doctors to explore social media: to harness diversity. Specifically, it's an argument for physicians as managers of diverse patient care teams, including nurses, dietitians, and social workers, as well as the patient's family, friends, and other patients like them.

Page outlines four conditions necessary for diversity to trump ability. For each of these, I consider how they relate to healthcare.

The problem must be difficult. Good health is famously difficult, and you need only look at the Dartmouth Atlas to see how they vary.

Individuals must know about the problem. There are a great many people, not just doctors, who know a whole lot about not just the health issue in question (the disease and treatment), but also the patient's habits and values

Incremental improvements must be suggestible by the group. Much of health, particularly for chronic conditions like diabetes and heart disease, are about continual optimizations that could be gathered by diverse suggestions.

The group must be large and genuinely diverse. Many patients, particularly those with chronic conditions, interact with a growing number of healthcare providers.


The Angry Medic said...

Okay when I read about your reason that doctors should harness social media I was like "sure we should, how else would we procrastinate/google shit we didn't understand/surf webcomics to keep ourselves sane?" Then you said "to harness diversity" and I felt...slightly dumb :P (a very accurate description if you ask any of my med school professors)

Seriously though, your post makes a lot of sense. Many doctors shy away entirely from social media, except perhaps in the US (the revolution has only begun in the UK) and this doesn't bode well. We need to change, just like our profession.

Keep it up!

Brian Shaw said...

Definitely true. Well put argument as to why we need more diversity in medicine. What's more, doctors often don't have all of the information when it comes to patients. Just think about the training track we heard about at #avoidablecare that allowed 4th year students to stay with a group of patients for a whole year in order to truly understand all of the social determinants of health and access to healthcare.

Diverse teams would allow all members to be informed by each other's perspectives and, just like you said, create incremental changes for the betterment of patients. Perhaps this would allow us to stop fetishizing(at least to such an extent) silver bullets in medicine.

astupple said...

Angry Medic- right on! Best of luck to you.

Brian- Thanks for your phrase "fetishizing silver bulltes in medicine." That's about the most mature insight I've come across in a good while. Stored. Check.