A PHILOSOPHER IN SEARCH OF A QUESTION
Medicine, Technology, and Progress, according to Dr. Jordan Shlain
Note: These are excerpts from an interview recorded for Dr. Gautam Gulati’s That’s Unusual podcast.
Dr. Jordan Shlain is an activist and philosopher in the field of health and medicine. He is the founder and chairman of Healthloop, and founder of Private Medical, a successful concierge medical practice. Dr. Shlain is also the founder and Editor-In-Chief of Tincture.
I actually think that medicine is really at its core, it’s conversation between two people trying to solve a problem and it’s usually between a doctor and a patient or now, more days, it’s a patient and the internet although that’s not actually a conversation, it’s a bunch of monologues going back and forth. I ask the internet a question, the internet gives me an answer but it’s not a dialog, it’s serial monologues. I think that we can fuse that with what is human nature which is am I being heard, is the response to the question that I just ask contextual and relevant to me. Of course, the internet can’t do that because it’s just an internet.
At a very high level, what medicine is and should be is an empathetic expert doctor or a nurse or somebody having a dialog with somebody with the lens of not just what’s the matter with you and how do we solve it but it’s what’s the matter with you and what matters to you. When you put those two things together, what you find is this alchemy of trust, engagement, empowerment and results. Because the truth is if you ask every patient for whatever their problem is, would you like the best outcome, the fastest with the least probability of side effects, adverse reactions, complications or becoming overtly and unnecessary medicalized, the answer is 100% yes every single time. If you ask a doctor, would you like your patients the same thing, they said yes.
On Jargon and Language
“We use the word readmission, what’s the readmission rate, we got to fix the readmission rate, then I think, “You know, what is a readmission?” If you crack open the word readmission, it’s a human being suffering somewhere that didn’t want to so why don’t we call readmission a human suffering failure of a system. We don’t because we don’t want to call ourselves out for failure, we want to come up with jargon. I think that one of the first steps that I’m really interested in recrafting language to remove jargon so we all call things what they really are, not what we hide behind to make ourselves feel good to carry on throughout our day while we’re harming people.”
Fundamentally, I believe that there are five things that technology needs to do in order to be meaningful to people. Because remember, technology doesn’t exist without people, we have to make it and we have to use it. Unfortunately, some of the people that make it have no idea who the people are and use it and that’s usually what happens in healthcare which is why we have the nightmare of a technology hairball at the moment in healthcare.
Every time I think about technology now, I ask myself which of the five does this have: Does it have preferences in it, does the user have the ability to have meaningful preferences? Is it contextual, meaning does it orient you to other things around you? Third, is it relevant, and does it mean something to you? Then the fourth one is is it actionable, can you take action at that moment? You got your preferences in there, it’s contextual, it’s relevant and with that, I make an action. The fifth one is, is it shareable, is it easy to share? Those are the Five attributes of technology where, if you have all five, you’ve got a winning combination and then it’s just a marketing and team building game and understanding what you need to do. Because, again, if you build something that helps people, ostensibly you’re going to make a big difference and win.
On Courageous Leadership
I feel like in healthcare, no one has courage to actually make change. They’re in their boardroom, they’re looking at a spreadsheet and they see that number going down, they may need to make it go up, that number is going up, they need to make it go down. What we need are people to say, “You know what? I’m actually going to do something unconventional because it’s the right thing to do.” It may cost me money in the short-term but I just feel like we need courage, leadership and the people willing to take … Courage requires taking risk and everyone is afraid of risk because they just want to get their paycheck and carry on. There are some healthcare leaders that are taking risks. The risk is based on courage and that courage is based on knowing that it’s the right thing to do and the eyes of history will remember them. I don’t see any healthcare CEOs getting bronzed statues but I think that in 10, 15 years now, we’re going to look back and there’s going to be a cohort of a few people that actually made the change.
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For the full interview, check out the That’s Unusual podcast.