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Heretics on Healthcare

January 1, 1998
by root
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HEALTHCARE HAS DEVELOPED a split personality in the decade that saw healthcare reform fizzle while managed care spread through the marketplace. We claim healthcare consumes too much of our national resources, but here we are

inching toward universal access. We’re pulling the plug on high-tech life-extending procedures, while manipulating fertility and supporting more and less viable premature deliveries. We want doctors to shift from treating our diseases to managing our health, but we won’t reimburse them for it. And we have yet to grasp the difference between medicine and healthcare anyway.

Into this stew of interests--of government, employers, payors and the public all intensely focused on a system that until only recently was the purview of practitioners--comes a whole new cadre of multidisciplinary thinkers, designers, scientists and computer technologists with tools like the Internet who have found each other and are quietly working out a new approach to healthcare.

There’s the architect who wonders why we’re still building hospitals for the 1950s. There’s the academic who thinks medical education is a boot camp that diverts many of the best potential doctors from practice. There are computer engineers who want to make "point of care" your home. With nothing to lose in abandoning the status quo, these outsiders are free to scrap today’s healthcare and imagine the healthcare that could be. And they will change it more in the coming decades than economic drivers of today are changing it now.

But focusing on what’s wrong with how we define and deliver healthcare doesn’t mean pointing fingers at its stewards of the past. In fact, that we could come to this crossroads at all suggests that healthcare is ready to transform itself; that our knowledge, understanding, tools and social motivation are mature enough to support a giant leap forward.

To what? That’s what these thinkers outside the box are trying to conceive--and then prototype. While they imagine how asthmatics could use biosensors to create a healthier environment, or how a Boston doctor could conduct a surgical procedure on a patient in Texas, they also back up and ask the BIG questions: What’s the goal of healthcare? Is it succeeding? Where could we be more successful? What are we missing entirely?

Everything that has gone before has brought us to this point in the evolution of medical care. Using the tools of their trades, these architects, researchers, scientists and engineers who are focusing now on healthcare will likely design something very new. It could be that for the first time since Hippocrates, a healthcare establishment will grow based not on managing care, but on managing health.


Editorial Director
Terry Monahan