Three Stages of a Profession

I propose the following stages of the medical profession:

Stage 1- From the time of Hippocrates and the birth of medicine, the best doctors knew how little they knew. Their main task was to humbly comfort.

Stage 2- Starting with antibiotics, knowledge started to equal treatment, and the best doctors sought as much knowledge as possible. Knowledge was power.

Stage 3- With the success of stage two, demographic shifts, and the advent of digital medicine, chronic disease abounds and the relevant knowledge is everywhere.

In this third and brand-new stage, I humbly propose that patients are best served not through seeking more knowledge, but in seeking creative and innovative applications of knowledge.

Medical education is run by the champions of stage 2, and they understandably encourage their charges to learn as much as possible.

Knowledge is certainly important, but patients need a medical education that serves stage 3. I wonder how to do that.

Singularity on a Plane

I had a delightful conversation on a plane (new for me) with a gentleman who was reading about Gettysburg. I was advocating futurism, he was celebrating history, but somehow, we both agreed with Ray Kurzweil. Things change at an ever increasing rate- what will happen when this rate is really, really fast?

Kurzweil's ideas are controversial, and I rarely share my enthusiasm for fear that I'll be labelled a freak. It took a conversation about the Civil War to build my confidence to defend Kurzweil here.

Kurzweil's main point is so simple, and yet so devastatingly undeniable, that even this older Gettysburg enthusiast supported it:

1. Things change. (Undeniable)
2. The pace of change itself is quickening (The Law of Accelerating Returns).
3. Will this continue to quicken? (History shows no significant slow-downs.)
4. What will happen when things change so fast that it's hard to keep up? (Kurzweil's guesses are fun.)
5. When will the pace of change reach this rate? (Read The Singularity is Near for more fun guesses.)

To dismiss these points as unimportant is cavalier. To dismiss those, like Kurzweil, who actively engage these questions and pose answers based on a solid look at evidence is not fair.

Why do I still feel nervous endorsing Kurzweil in public?

The Head Down: Alone together

I've started conversing with strangers in elevators.

After reading Sherry Turkle's Alone Together: Why we expect more from our technology and less from each other, I've become uncomfortable when I find myself with three or four others, head down, peering at my phone in an elevator. Or walking past someone in the hall, head down, both of us making our way slowly by sheer dint of peripheral vision.  

Before reading Turkle (and really, up until the epilogue of her book), I was dismissive of any critique of the head down. Our phones connect us in rich, genuine ways, with those we care about. They also forge new relationships with those we might not meet otherwise. Best of all, phones enable us to transcend the fickle bondage of location and even time to interact with those who otherwise just aren't here. Most of Turkle's book fell flat as she, like so many other critics, brushed these attributes aside, and instead embraced the tired bromides about why I don't "just call" my "real" friends.  

Now, I've admitted to myself that I just feel uncomfortable when head down. When I see the head down, I react similarly to when I see teenagers all conforming to the same fashion trend, clearly more interested in fitting in than being themselves.

And this, according to thinkers from Ken Wilber to Clay Shirky and, most recently, Michael Chorost*, is the real issue. Connectedness is fitting in, at the opposite end of a spectrum from disconnection, which is standing out. Our lives are somewhere in between, and our personalities place us closer to one pole or the other. Neither pole is right or wrong, and where you are depends on your comfort.

I like to stand out, but that's just me. I try not to give other people a hard time for when and where and how often they prefer to fit in (so long as they stop meandering down the hallway), and I certainly won't castigate our new way of life as somehow a degradation of a better time. 

Maybe the other stand out people are just upset because they're losing what used to be a captive audience?

*Chorost's new book World Wide Mind is really a great piece of writing, as well as eye-opening. 

How A Disruptive App Disrupts: Skin of Mine

Skin of Mine is an impressive tool that allows the analysis of one's skin condition (from acne to psoriasis, moles, vitiligo, and more) with nothing more than an iPhone. 

To appreciate the nature of a disruptive innovation, see how this app changes the very structure of the doctor-patient relationship.

Traditional:

1. Call primary care doctor and schedule appointment. 

2. Take time off from work etc. to see primary doc.

3. Get referral to dermatologist.

4. Call dermatologist to schedule visit.

5. Take time off from work etc. to see dermatologist. 

6. Act on diagnosis and prescription.

7. Call to schedule appropriate follow up.

Disruptive:

1. Take picture, complete a questionnaire, and submit to the expert of your choice.

2. Receive diagnosis, prescription, and therapeutic advice within 24 hours.

3. Act on diagnosis and prescription.

4. Call or use app to schedule appropriate follow up.

Crucial Points:

The app obviates two office visits and the time needed off from work.

The app is faster.

One health care provider and many staff are cut out of the loop.

The patient has a personal record of what happened.

Note: I have no connection with or support from Skin of Mine