Archive for January, 2010
Several readers of the ICSI Health Care Blog have asked me about behavioral economics which has been mentioned in some posts (http://bit.ly/4uZNlH) and (http://bit.ly/49q4Uy). I am by no means an expert in this area, but I am happy to share with you an annotated bibliography of the books that have educated me on the topic.
I’m all about networking, developing relationships, and maintaining a distance if possible (after all I am Norwegian) in advancing my efforts in collaborating with others. I’m struck that while I’m often compared to an “Energizer Bunny” at work, I tend to more closely resemble a hermit when I walk away from the job. As I reflect, it’s getting less and less frequently that I walk away from the job, but that’s another story.
The task of health care reform in 21st century America is to decrease per-capita cost of care and to increase the quality of care delivered to patients. It’s complicated. A famous Rand study concluded that Americans only receive 55% of the care that science dictates. Patients intuitively believe that more health care is always beneficial. Medicare reformers would like to do comparative effectiveness research so that CMS and private insurers could wind up paying only for therapy that actually works. Some estimate that 30% of all care delivered in the United States is waste. What some call waste, others label revenue, and Atul Gawande becomes famous for identifying waste/revenue in McAllen, Texas (http://bit.ly/ENlli).
My ICSI colleague Claire Neely recently mentioned that the classic Chris Argyris article “Teaching Smart People How to Learn” had been an “aha” moment in her efforts to learn how to better teach and reach physicians. While I don’t think I have ever read that article, I had been impressed with Chris Argyris, especially his work with Donald Schoen. Claire emailed me the article, and it really is a classic that needs to be read. (http://www.velinleadership.com/downloads/chris_argyris_learning.pdf)
As I was catching up on my readings from Aesop’s fables, several issues came to my mind. First, and foremost, what drives someone to consider the perusal of ancient fables as an exercise worth considering? I have to admit, that may be a question for pondering, causing internal reflection which might lead to valuable insights into my true persona. But let’s leave that for another day. Second, the value of a fable is in it’s application to today’s situations, providing an imagery which simplifies or magnifies our thinking. Such is it with one of Aesop’s less known fables—The Stomach and the Body.
The drive to find solutions for the deficiencies in our health care system is accelerating as the issues of cost, poor quality, limited access, poor coordination, disparities, and others become more public. The debates on health care reform, with the recent influx of large amounts of stimulus money, have led to a proliferation of projects and initiatives which will hopefully provide direction in the journey for a transformed health care delivery system.
One of my blog posts (http://icsihealthcareblog.wordpress.com/2009/12/07/kent-bottles-good-evil-niebuhr-buddhism-health-care-reform-and-twitter/) created concern about my mental state. I received a very nice Twitter direct message from @ePatientDave and my colleague at work @jtrevis noted that my dark blog posts seemed to be less popular than the sunnier ones. While I would never want to be in a “normal” mental state, I do think that seeing the world and people clearly for what they are is preferable and more effective than being controlled by our wishes or fears.