Many people have noticed that healthcare has become more "industrialized." As healthcare has changed, with productivity and output being primary, the provider becomes a "factory worker" and the patient becomes a "product." As such, the provider and the patient become increasingly distanced from each other.
Not enough doctors? Then make the doctor the foreman. Make the other providers, such as nurse practitioners and physician's assistants, part of their "line", under supervision. Of course, a manager and a coordinator are needed on top of that. And finally, don’t forget the chief financial officer (CFO) and the Utility Commission.
We doubt this will change, but just like in other industries (it hurts to describe a giving, healing profession as an "industry"), there are constant new movements and experiments. Many of these fail; some work. An analog would be during the late Victorian period when the Arts and Crafts movement developed. To quote Monica Obiniski:
"The Arts and Crafts movement did not promote a particular style, but it did advocate reform as part of its philosophy and instigated a critique of industrial labor; as modern machines replaced workers, Arts and Crafts proponents called for an end to the division of labor and advanced the designer as craftsman."
I liken this Arts and Crafts period to the period in medicine of my father's generation, when doctors might be paid with eggs from his chicken, the pace of medicine was slow, and patients and doctors had a lifelong relationship. There was a prioritization of human values over sheer productivity. And there was a respect for craft and quality rather than simply what cost the least to make.
The movement ultimately receded; it was largely gone by the 1920s and the acceptance of modernity in the machine age. In a parallel evolution, this "arts and crafts" period of medicine was largely gone by the middle of my career.
Interestingly, the Arts and Crafts movement in American is experiencing a rebirth -- in large part, thanks to technology supporting it. For instance, Etsy, the worldwide online craft marketplace with millions of vendors making handmade goods and selling them online, started in 2008. Since then, I believe that we've seen a re-valuing of craftspeople -- whether makers of chocolate or furniture or leather goods -- and the valuing of thoughtful "industry," using new solutions, often supported by technology.
So what does this have to do with healthcare collaboration and care coordination and the use of technology such as iClickCare in the current context of healthcare? I believe that healthcare is at the very beginning of a similar "craft"rebirth. For instance, direct care and concierge medicine are gaining in popularity. Neither are new; both harken back to the medical context of my father's generation and the early decades of my practice -- that slow, thoughtful, craft-focused practice of medicine.
And I see healthcare providers around the country claiming and demonstrating that the principles of excellent, compassionate, and comforting care can be empowered by working together using technology to break down silos.
Of course, even if we say that the "healthcare factory" is inevitable, if it uses a collaboration based workflow, it can produce a better product (a healthy and peaceful patient) by using telehealth. (Needless to say, reduce burnout in the providers!) Medical collaboration and care coordination supported by technology can decrease waste and reduce "manufacturing errors."
It is our responsibility to remember the good of the past while embracing the promise of the present and future. It is our responsibility to design and craft our prescriptions and plans for our patients and advocate and promote the value of the individual, no matter if the individual is your patient or yourself. Technology in medicine is part of out future. But it's up to us as to whether that future also includes a return to our values.
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