As Albert Einstein has famously said, "We cannot solve our problems with the same thinking we used when we created them." Unfortunately, in our modern world of medicine the systems that drive medical treatment – mainly those who pay for and administrate it – have worked to eliminate most efforts that color outside of the lines. It stifles innovation and herds the majority of healthcare into pre-determined channels in the name of maximizing efficiency, increasing patient safety and minimizing loss and risk – all laudable goals, and yet…
This is nothing to be surprised by since so much of our healthcare in the U.S. is paid for by Federal and State governments whose goal is to create stability and predictability. But what is shocking is how many physicians are "taking it lying down," knowing full well that more harm has been done to the sacred physician-patient relationship because of these pressures. Many physicians – especially those graduating with huge medical school bills – are forced to be more interested in financial and professional security than they are with the professional autonomy and creativity that their predecessors enjoyed.
After a recent meeting of a physician wellness committee, one of the doctors said, "Boy I wish we had more research about that to find out what kind of interventions there might be to do with that problem." I snapped my fingers – almost as if breaking a hypnotic spell – and said "Mary! (name changed to protect the innocent) you and I know well enough by gut instinct what the solutions are and we don't need research to start on interventions!" She and another doctor said "Omigosh! You're right, we've been so conditioned to think that way. It paralyzes us."
Don't get me wrong: I am so grateful for the peer-reviewed research that goes into making medicinemore reliable and have no desire to return to snake-oil salesmen hawking their "creations" to anyone who will buy them. However, when it comes to the problems facing healthcare itself, we have to encourage each other to scribble outside the lines a little more. Individually, this is hard to get away with, but collectively enough doctors can make a big enough stink that "the system" is forced to listen and change.
What do you do to remain creative as a physician? Please comment below.