Innovation means change. Doing or achieving something in a new, improved way inevitably means changing what was done before. And yet one of the most often-repeated observations in health care is that “doctors are resistant to change”.
In my TEDMED talk I examined what I believe underlies doctors’ behaviour and why I think their so-called resistance is a lazy interpretation of a more complex problem.
In essence, doctors are taught to doubt, as this is what helps them make the right decision for their patients. This same behavior also makes them build mechanisms to ensure that the system they work in is safe and effective. I call these mechanisms the “web of trust”.
Innovations disrupt the web of trust, which causes discomfort for doctors. This manifests as resistance. Innovators need to better understand the role of trust in health care (or why doctors doubt) in order to build trust into their innovations. Few, if any, do, which is why I think most current innovations in health care are bound to fail.
But health care is about more than doctors. The burden of disease is changing from episodic things that were treated in hospital to chronic things that are part of our daily lives. As a result citizens want more understanding and control of their daily health, which is why we’re seeing more and more innovation outside the traditional boundaries of health care institutions.
It would be a mistake, though, to see the citizen space in isolation. Instead, it’s part of a continuum that extends into primary and then specialist care. This means that whatever tools consumers use to manage their health need to be trusted by the clinicians that may ultimately be called upon. Without that trust, care will be fragmented and perhaps ineffectual.
Other industries have learnt how to create these new, distributed forms of trust. In the hotel industry, for instance, AirBnB has enabled ordinary people to rent their spare rooms to strangers. Their website is specifically designed to provide the kind of information people look for when deciding whether to trust someone, either as a host or a guest. Although there is a specific technology that has made all this possible (peer-to-peer platforms, often abbreviated to P2P), it’s about more than just technology. It’s about society embracing opportunity made possible by new forms of trust.
With more and more citizens taking charge of their health, traditional health care needs to understand and embrace a new, distributed form of trust. It’s only with such trust in place will radical innovations that tackle today’s seemingly intractable health challenges be possible. Riffing off P2P, I call this new form of trust, “We2C” – how we, the people, can lead and engage clinicians in a productive manner underpinned by trust.
Competing interests: I am a paid consultant to TEDMED, although I was not paid to talk.
This post was co-published on the TEDMED blog (with a slightly different title) and my original blog, Optimising Clinical Knowledge.