BioX at Stanford and a Change in Focus

I attended the BioX symposium yesterday at Stanford. BioX funds initiatives at Stanford that encourage cooperation across disciplines. It was a great opportunity to see first hand many new technologies for diagnostics that dramatically improve health and relieve suffering. From talking to many bright people and hearing what they have to say, I found a few common points.

1. Most people in medicine are really passionate about what they do. (So am I)
2. Most people in medicine are really brilliant and knowledgeable.
3. Most people in medicine really want to advance their practice methods.
4. Doctors are used to being hailed as experts and believe in their own expertise.

The question that I am now trying to focus on is how does one leverage these points above to encourage medical professionals to support change. If we look at the role of technology in all other fields, it has lowered costs and improved accuracy through automation. Not in medicine. Key to the realization of benefits, such as cost reduction, is changing business processes to leverage the new capabilities and cut jobs. Without changing methods, attitudes, and employee streamlining, there can be no benefit from new technology. Thus, technology can be viewed as a replacement for doctors. People don't like the prospect of working themselves out of a job.

The medical community is beginning to slowly embrace the concept of "Personalized" medicine and "Preventative" medicine. The challenge that I have when speaking with doctors and BioTech researchers is that change can easily become threatening or adversarial. Diagnostics mean facts, and facts are better than opinions. Diagnostics inevitably reduce the room for physician judgment and empower people to make their own decisions. They also have the power to reveal physician mistakes.

When one points out that computer science has advanced Systems and Information Theory way beyond medicine, it has the potential to open a pandora's box. Many have heard the arguments, but don't really grasp it. Many sort of get it, but don't recognize that they are witnessing a paradigm shift. Some are busy making it happen. The real key for me to figure out is how does one "Sell" the benefits of radical change on the basis that it will benefit both patients and doctors? I think the keys are to listen and build trust first and to then position new ideas as the extension of existing and accepted ideas.

Personally, I would like to see physicians redeploy their time on improving access and creating healthier populations for the same dollar spent. For example, people may no longer suffer from catastrophic cancer because cancer will be caught early when it is still easy and cheap to treat. As a result, there would be more dollars elsewhere for basic health care for patients currently under-served. If those formerly under-served patients then avoided the ER or themselves got preventative health care, then there would be even more dollars saved to go to the next under-served patient. Just as important, our working population would be more productive without catastrophic illness, and thus pay more taxes or shrink health care as a percentage of the budget. This point is especially important for baby boomers who want or need to stay in the workplace.

As more health care became productized, it could be exported around the world to further increase access and leverage the same R&D cost over a larger patient base. Cost per patient could plummet, easing the burden on families. Through new and more productive research methods (Systems and Info Theory), orphaned illnesses could become economical to treat. Ultimately, physicians and BioTech researchers would still have plenty to do. It's that their jobs have to be eliminated so that they can perform new ones. At the same time, we would get more value for their time and lessen the burden on society. I believe that the greatest threat to this vision is not physicians per se, but their leaders who derive power and wealth from the current system. Ultimately, I believe that the best moral leadership is leadership that accomplishes its purpose. I believe that a thing acquires purpose by its moral rightness. Perhaps there is common ground in that between advocates of new technology and those who must implement it.