Comfortably Numb with “Crisis”
Another day, another "urgent crisis".
In his Q&A with reporters after delivering remarks at the National Press Club this week (see “AI Can Be a Boon to Clinicians -- If Used Correctly, Says AMA President”), American Medical Association president and "digital health guru" Jesse Ehrenfeld, MD rang the alarm bell on yet another mushrooming crisis with the American Way of Healthcare, one that positions the country in the same messy quadrant as Liberia, New Zealand, Greece and the United Kingdom:
"The physician shortage that we have long feared -- and warned was on the horizon -- is here," he said. "It's an urgent crisis ... hitting every corner of this country – urban and rural – with the most direct impact hitting families with high needs and limited means. Physicians everywhere — across every state and specialty — continue to carry tremendous burdens that have us frustrated, burned out, abandoning hope … and in increasingly worrying numbers, turning our backs on the profession we’ve dedicated our lives to."
Put aside for the moment the AMA's opposition to expand pharmacists' scope of practice, and the mind-numbing, monotonous repetition of a "bipartisan" solution from a divisive and dysfunctional government. Bilious rhetoric pours from members of Congress presiding over their dilapidated institution, writes George F. Will in an opinion piece for the Washington Post last week (“As ominous threats rise, the U.S. is mired in moronic, clownish politics”). “Never has there been such a disjunction between the seriousness of the nation’s problems and the irresponsibility of its political class,”
His point:
The unfolding presidential campaign is doing nothing to elucidate intelligent responses to two regional wars abroad and fiscal incontinence at home. About the nation’s peril, consider this:
“The United States now confronts graver threats to its security than it has in decades, perhaps ever. Never before has it faced four allied antagonists at the same time — Russia, China, North Korea, and Iran — whose collective nuclear arsenal could within a few years be nearly double the size of its own. Not since the Korean War has the United States had to contend with powerful military rivals in both Europe and Asia. And no one alive can remember a time when an adversary had as much economic, scientific, technological, and military power as China does today.”
I would suggest the root problem is this: we need different words to reframe the game.
In the same way that “horseless carriage” was used to describe the first automobiles, legacy narratives are no guide to invent different futures. It's new strategy stories, crafted and positioned with a unique combination of words, that can fertilize the PowerPoints and persuade with novel vision. We have to get off the comfortable mental furniture keeping the status quo in place. And that process starts with a brick through the window of convention and cliche.
In the spirit of offering something constructive, here’s a thought experiment. What would be the kinetic potential of:
Policy innovation where the United States invests in the medical schools and training of healthcare professional in Latin America, at Marshall Plan scale? Not as a way to "create smoother pathways for foreign-trained physicians" to practice in the United States per se, but as a spark for economic development and resilience in Mexico, Venezuela, Honduras, Ecuador and Nicaragua?
Policy innovation where the American Medical Association + American Pharmacists Association + PhRMA combine energy and investment as a ‘market set’ to construct a new platform for economic innovation that positions healthcare as the real wealth of nations?
Policy innovation where the United States Department of Defense + Harvard’s Growth Lab + the American Medical collaborate to elevate healthcare as a new form of economic statecraft, another tool in the "The Arsenal of Democracy" as powerful as an American aircraft carrier strike group?
We are on a road to nowhere because we are comfortably numb with the status quo. It's time to start seeing and doing with a different lens, a whole new taxonomy to energize strategic imagination, something original in the content and communications to inspire.
Until that happens, we can expect another 50 years of strategic atrophy, with leaders at conferences and speaking events imploring someone, anyone 'out there' somewhere in the ether, to "fix" the crisis in healthcare, the crisis in the environment, the crisis in immigration, the crisis in demographics, the crisis in mental health, the crisis in poverty, the crisis in crime, the crisis in the Middle East.....
Hopefully, of course, all fixed with everyone’s Golden Ticket: artificial intelligence.
"There is a little box that you can put in a retail pharmacy -- you can put it in a primary care office, you can put it anywhere you want," Ehrenfeld explained in what was billed as a national address. "Any high school-educated operator can put a patient in front of it, take pictures of the retinas, and the AI is so good and the image recognition is so good that the company carries malpractice insurance on the device."
His was the sight and sound of a Silicon Valley visionary, the bold ambition of what technology can do.
"Suddenly you can screen millions of patients overnight right with this device, and then the ophthalmologist only has to see the patients with disease," he added. "It changes the workflow, it augments the capabilities, it scales the capacity of the workforce, and those kinds of tools I think are really exciting and where AI is going to make a big difference."
I don’t see the bigness. The novelty. The originality.
Technology “can” do anything. But without simultaneous economic innovation, it’s the sound of one hand clapping.
Better to step off into a corner for a different review of reality, and then put in place a deliberate process of creative destruction. Bring pieces and parts together in a unique cognitive pattern, create a new bundle of knowhow, position outcomes at the center of new economic thinking, compete through new systems of engagement.
Because this mode of thinking isn’t working.
/ jgs
John G. Singer is Executive Director of Blue Spoon Consulting, the global leader in positioning strategy at a system level. Blue Spoon specializes in constructing new industry ecosystems.