Tuesday, March 29, 2011

The Great Divide: Doctors vs Innovators

Time Magazine eLEGS

I recently listened to a talk about the future of exoskeleton technology.  It seems that Berkeley Bionics is making great 'strides', helping wheel-chair bound individuals walk again.  My college days were packed with discussions of biomechanics and gait analysis so, of course, the topic is of great interest to me.  However, if conceivable, what I find more interesting is that when it comes to discussion of modern science and medical technologies inevitably, the practice of medicine is vilified. 

The woman demonstrating the technology has been paralyzed for nineteen years after taking a sudden somersault while skiing in her twenties.  She described her despair in the hospital bed, which was magnified by the doctor who "strolled in and told me I'd never walk again.  And with that he shattered me".  Since then, she had relearned how to ski and rock climb, but with this device, she was walking for the first time. Her tone was defiant, as if she thought her doctor would have wanted to be right more than for her to be healed.

As a teenage, I worked at the Arnold P. Gold Foundation, a non-profit that focused on teaching doctors to treat patients more humanistically.  Many of us, I'm sure, have read statistics on the mind-body connection, the placebo effect, the importance of hopefulness in treatment.  I saw it with my own grandmother. This is not the first time I have heard such a negative perception of physician care.  But more and more often I hear these sentiments espoused by the innovation community, with the most vitriol of all.  The attacks come both in professional and personal contexts.  Oddly enough, it often becomes medicine versus innovation.

I believe, what it really distills down to is that though these two groups seem to have similar goals, they actually have diametrically different views of patient care with much differing time horizons.  In the most idealistic situation, doctors are trained experts with an encyclopedic knowledge about disease and ways to fight it.  However, they are dealing from a very finite stack of answers and the very basis of their profession tells them, that all diagnosis and prognosis must fall within that Rolodex.  Everything is reduced to statistical norms within mortality and morbidity charts.  Their focus is primarily in the past.  They treat one patient at a time, informed by their education and experience, winning some, losing others, hoping that over enough cases, they can beat the house. 

The science and technology community is predominantly a different breed of animal who thinks almost entirely of the future.  Innovators believe that the game can always be rigged to improve the odds.  They have faith that given enough analytical capital--- man, microprocessor, experimentation--- anything is possible.  This illogical blindly optimistic view of the world provide the fumes that keep them working even when chances seem slim.  To them answers are never finite, and thus the Rolodex is a dynamic one.  And lastly, when they hit, they hit big, effecting the life of not just one patient, but possibly millions.

So when these two communities are forced into the same room, whether by industry or illness, they can't understand each other.  The doctor, in the trenches daily, patient-to-patient, must see the innovator as a wild-eyed dreamer. While the innovator, creating a device or cure ten, twenty, or thirty years into the future sees the physician as lacking hope, vision, and having the audacity to think he has all the answers . 

The irony is that they both need each other--- and it's not just about creation and implementation.

I hear that job satisfaction amongst physicians is at an all time low.  Doctors are a disheartened and disillusioned bunch and they deserve a little hope and faith drizzled into their profession. Maybe innovators could share their flame of optimism.  A tiny flicker could burn despite all the negativity medical professionals face.  Maybe then they could impart more of it to their patients too.  And I'll be the first to admit, many times innovators can be dreamers.  They could stand to learn more about the current needs of patients, develop a greater sense of urgency around solutions and visualize the real people they would be helping with this great abstract idea. 

Past, present and future.  Grounded and hopeful.  Micro and macro.  Doctors and innovators would do well to realize they are on the same team.