We talk a lot about medical collaboration. The best healthcare providers know that we give better care when we work together. Medical collaboration lets us make better diagnoses, do care coordination more effectively, teach the next generation of providers, and prevent patients or findings from falling between the cracks.
And we don't have hard data on it, but all signs point toward providers being increasingly "siloed." Specialization increases every year. The amount of time that we have to discuss a good case with a colleague is non-existent. The disincentives (HIPAA, etc) that exist to work with other providers increase all the time.
But it's often hard to pin down the ways that this is happening, and to what extent. An interesting parallel to this dynamic is the polarization we are seeing in our political system. We hear a lot of talk about how there is a lot of division and polarization in the US political context, but similarly, we often can't pinned down whether this is really true, and to what extent.
So I was fascinated to see an academic study that quantified and visualized the level of cooperation between Democrats and Republicans in the U.S. House of Representatives from 1949 until 2012.
Their findings were pretty stark: "We find that despite short-term fluctuations, partisanship or non-cooperation in the U.S. Congress has been increasing exponentially for over 60 years with no sign of abating or reversing. Yet, a group of representatives continue to cooperate across party lines despite growing partisanship." This image shows the ways that the polarization has occurred over that period of time. Each dot is a representative, and lines connecting pairs of representatives who vote together. The dots for each representative are placed according to how frequently the Representatives vote together overall.
As I said we don't have hard data about it, but our anecdotal observation is that polarization, non-cooperation, and siloing of healthcare providers has also risen exponentially, during about the same time period.
And just as US citizens suffer when politicians don't cooperate, patients suffer when providers don't collaborate. Here's why:
1. Trust, satisfaction, and sustainability degrade. Cooperation and collaboration are valuable ends in themselves for the mental health and efficacy of healthcare providers. With so many healthcare providers suffering from burnout, feeling separate from each other and our patients can hurt our health, our sustainability as providers, and our performance.
2. Results aren't as good. Whether it is the citizens of the US or our patients that we're talking about, our results can be very poor when we don't work together effectively. Medical collaboration isn't a "nice to have" -- it's a crucial component of providing the best possible standard of care.
Ultimately, the only solution to fixing the polarization problem is to start drawing more lines between more congresspeople (in the case of politics) and between our colleagues in the medical world. It is said that "there is no path; the path is made by walking." Similarly, the only way to a more connected and cooperative world is by connecting and cooperating. We can give you the telemedicine tool -- and it's up to you to do it.