What is the answer for medicine?

This entry is part 5 of 5 in the series The History of Thinking Medicine

We’ve learnt about medicine’s illustrious thinking past, and contrasted it with some limitations in medical education, with the proof being the frightening statistics of the results of medical error. We’ve seen how Aviation solved its own crisis of error. So what can Medicine do about this state of affairs?

To start with, eradicating doctors won’t help – the effects of illness and injury, if left untreated, are much worse than what even the very worst doctors can inflict. Consider, a few hundred years ago you were lucky to get out of your forties alive and intact. We don’t want to go back there – going backwards is not an option.

Throwing out technology, investigations, medicines, surgery and the tens of thousands of enormous medical breakthroughs and returning to eating roots and shiny-leaved shrubs is not the answer.

But then, neither is assuming that all answers lie in our technology and knowledge and assuming a stance (even an unaware, unconscious one) that doctors are right, they seldom if ever make mistakes and their opinions and judgement are to remain hallowed and untouched.

Doctors are people – in all their glorious human imperfection!  

I know – I’m one of them, and I couldn’t find my car keys this morning – again! I have a brain; it evolved over much time and has tremendous abilities that give me a wonderful edge in life, but it has some bizarre quirks and limitations as well. It’s an organic thing, it’s not perfect, and that’s that.

So expecting our doctors to be perfect, to be all-knowing, all-powerful, to be able to read our minds and see the future is not the answer either. 

Aviation didn’t ban aircraft.  Nor did it train pilots harder and expect them to be superhuman.  It designed around humans and their thinking by understanding it well and learning how to design things that tended to minimize mistakes and by discovering which designs tended to cause mistakes.

The answer for Medicine must surely lie in understanding people and how they think.

That’s what Aviation has done so successfully. Understand how people think and apply that to medicine and you understand how ethical and dedicated professionals with sometimes encyclopedic knowledge and sublime skills can make ridiculously silly mistakes and jeopardize their patients’ lives through the equivalent of losing their car keys.

Understanding how human beings think is called “cognitive psychology.”

Optimizing the health of individuals is called the “practice of medicine”.

Realizing that we need to apply the knowledge of thinking to the practice of Medicine is the great mental paradigm shift that unlocks the door to better medical outcomes. 

Understanding how cognitive psychology can be applied to the practice of medicine covers our paradigms, culture, values, norms, thinking (subconscious, non-conscious and conscious), memory, attitudes – all things that are very human in nature. We are, after all, just people – all of us; both healthcare practitioners and patients. We are doing brilliantly on the technology front in medicine, but not so well on the people side. That’s what we need to work on now.

Following its alarming and disturbing data, the IOM didn’t leave us hanging. It got together with a variety of experts and outlined a “2020 vision” explaining what things we need to be trying to do – in short, what a healthcare system with a much lower error rate would look like. This site is very much about helping people everywhere to understand that 2020 vision and how to get to it. It should not be a vision that only ivory tower academics and doctors understand – it is a vision for all people.

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