Category Archives: #healthcosts

The Healthcare Lizards

Healthcare Is Full Of Lizards

You read the headline correctly.

Healthcare is full of lizards.

Not the cold blooded amphibian type that slither and scamper around the ground. I am talking about the 2 legged, warm blooded type of lizards, the humans working in the hospitals.

Bare with me for a moment.

All of us have a lizard brain. It is that evolutionary portion of the brain called the amygdala. The amygdala is responsible for the flight or fight response. The portion of the brain that focuses on eating, reproduction, and safety.

Over the past few weeks as I was traveling and talking to hospital executives, I heard a lot of discussion on how people are waiting, or needing more data, or cannot do something.

At one point I asked a Hospital CEO the following question,

“Do you want to be like everyone else, paid the same, and part of the middle or do you want to be a market leader, get preferential status, and a premium revenue stream?”

Of course the response was they want the latter of the two options.

Yet the lizard brain is preventing them, their team, and the rest of the organization to move forward due to fear. The fear of not having all the information, the fear of maybe being wrong, and the fear of doing the work and not getting the reward. The fear of doing the work, being on the hook, and stepping up to take responsibility.

The preference is to let someone else do the work.

To ride the wave, be happy with being in the middle, getting a guarantee, and feeling good about getting something rather than nothing.

Steven Pressfield (author of War of Art) calls it the “resistance.” The critic that talks in our ear and tells us to stop. To stop short before doing something extraordinary, and just be satisfied with being extra ordinary.

Healthcare is full of lizards. Healthcare is full of mediocrity.

Remember it is a choice.

A choice at the N of 1.

As always you can feel free to email me at cancergeek@gmail.com or follow me on Twitter @cancergeek

~Cancergeek

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Patients Created Crowdsourcing

crowd

Crowdsourcing is a phenomena that was coined in 2005 by Jeff Howe and Mark Robinson, editors at Wired magazine. Their initial definition was specific to how businesses at that time were were leveraging the internet to outsource work to individuals.

3 years later, Daren C. Brabham was the first person to use the term in a scholarly article. He also wrote a book by the same name, Crowdsourcing, in 2013. (Jeff Howe wrote a book by the same title earlier in 2009: find it here)

Daren’s definition in his paper was the following:

Crowdsourcing is a type of participative online activity in which an individual, an institution, a non-profit organization, or company proposes to a group of individuals of varying knowledge, heterogeneity, and number, via a flexible open call, the voluntary undertaking of a task. The undertaking of the task, of variable complexity and modularity, and in which the crowd should participate bringing their work, money, knowledge and/or experience, always entails mutual benefit. The user will receive the satisfaction of a given type of need, be it economic, social recognition, self-esteem, or the development of individual skills, while the crowdsourcer will obtain and utilize to their advantage that which the user has brought to the venture, whose form will depend on the type of activity undertaken.

I believe that healthcare was the original pioneers in “crowdsourcing.”

I can remember being a small boy, and my aunts, uncles, and grandparents always calling my mother, a nurse, and asking her about their symptoms. They would discuss their aches, pains, coughs, phlegm, and number of days with my mother.

After seeing their physician, they again would call my mother and ask her about what the doctor told them. They would ask her questions about the diagnosis, the medications, the doctors recommendations.

As I moved into my own clinical expertise in oncology, I have had several family members, friends, and professional colleagues call and ask me the same types of questions.

I started to think, patients have always done crowdsourcing for their diagnosis. Healthcare just never had a formal name for it. (full disclosure, I give the “hat tip” to Dr. Krishnaraj for planting the thought for this post in my mind)

Screen Shot 2015-01-27 at 10.04.22 AM

In the days before the internet, it took place via a phone call. We would wake up, not feel well, pick up the phone, call our trusted friend, talk about how we are feeling, and they would weigh in with their opinion on your diagnosis.

We would go to the store, buy some medicine, and see what happens. Maybe after a few days we finally go see a physician. As soon as we arrived home, we would pick up the phone and share with the diagnosis and recommendations with our friend.

Original Crowdsourcing.jpg

Today, it is even faster. We have access to more people. Instead of being able to call and talk to one person, we can instantaneously go to Dr. Google, input our symptoms, and come up with a self diagnosis in seconds.

We can now turn to blogs, websites, Facebook, Twitter, Instagram, Pinterest, and many other sites to connect with people and get their opinion. We can connect with medical societies, hospitals, online physicians, and quacks. We can even connect with children posing as medical professionals.

Modern Crowdsourcing.jpg

We can input out our signs and symptoms into a search engine and easily receive a diagnosis.

The diagnosis may not be correct, but we can receive one none the less.

We want an answer to our “What” question. (post here: Diagnosis Is King) Since we have immediate access to the internet, friends, family, and colleagues, we crowdsource their knowledge to alleviate our own anxiety.

To arrive at an answer to the “What” question.

Even though magazines like Wired, Inc, and the cool startup culture of Silicon Valley are known for their crowdsourcing endeavors, patients have always used “crowdsourcing” when it relates to their diagnosis.

Patients created crowdsourcing. Healthcare just never acknowledged it.

As I mentioned during the #JACR discussion, if the “insiders” of healthcare can begin to leverage technology to disseminate and leverage all of the medical knowledge globally, in a crowdsource manner, maybe we will bend the cost curve. Increase access, improve wait time, and decrease patient anxiety.

Maybe, just maybe, healthcare “insiders” will finally learn from what is already happening outside the four walls of their own organizations….

Patients always have, are today, and always will crowdsource their diagnosis.

Don’t ignore the crowd. The crowd is full of your patients. Join the crowd. Listen to understand, not to respond. The crowd will tell you what they need.

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek

~CancerGeek