Fixing Healthcare by Tearing Down Silos

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There is no doubt in my mind, and in many other people's mind that the road we are on to the future of health and medicine is not a road we want to be on. I think there's very little consensus for the status quo. I think you can pick a 100 people off the street whether they be policy makers, doctors, nurses, patients, hospital people, whether they be people in the food and wellness work, roads of stress, palliative care, you pick it.

Nobody seems very happy with the road we are on. Nobody says, boy, can't wait to get to that future. Everybody is in health and wellness where within all of us our lives are deeply and critically affected. If not immediately, then it's our children, our brothers and sisters, our mothers and fathers.

Now, there isn't a person alive who isn't intimately engaged in the complex dance of life and death, that is health and wellness. We all agree we're on the wrong road. That tells you something, but the road we're on is the result of very intense pressures, very intense competition for resources, very intense beliefs that clash with each other, and those beliefs are not just political beliefs about access or payment systems.

They're even beliefs about what constitutes wellness, what constitutes a good lifestyle, what constitutes healthy behaviour towards your children or your spouse. There are fundamentally and critical disagreements about this. People tend to confuse health care with health and medicine.

Health care is the delivery system of what we know about health and medicine. America has a sick care system, not a health care system which is when you get sick, you enter a system to try to get well or to try to manage. If you have an incurable issue then you have to try to manage that incurable or chronic system.

So, we tend to be caught up in this discussion about health care because it's the crisis de jure, and so we tend to think, wow, it's all about health care and health care crisis. The fact of the matter is that's a very defined, but not as big as you think subset of the notion of health and wellness.

So, for example, all the choices of what you eat are directly reflected in health and wellness. Your choices of stress, and lifestyle, and job are about health and wellness. Your relationship with a spouse or your children are all about mental health and wellness. Your relationship with your parents are about that too.

Your environmental factors are really about wellness, your exposition to toxins and environmental factors. So when we talk about health and medicine, what you find is an extraordinary number of silos no matter where you go. You find more and more experts going deeper and deeper into their specialty, their specialization.

You find very few generalists because the system doesn't select for generalists. It doesn't pay them, it doesn't reward them, it doesn't honor them. So everybody becomes a specialist which is wonderful if you need a specialist, but unfortunately, you need generalists. You also need people who are not living in their silo, and these silos are not just silos in medicine.

They're silos in the educational system, they're silos in the legal system, they're silos in the culture, they're silos in every area we look. Unfortunately, without connective tissue between those silos, we are condemning ourselves to not taking the best of thinking, to not taking the best of what we learn across all the many fields where we constantly innovate, and we are fundamentally trapping ourselves in narrow little worlds, and no matter how brilliant you are, the guy next to you or the woman down the hall maybe brilliant in totally different ways, and when you bring people together who never would need each other, when you bring disciplines together, and touch each other who would never normally even think of talking to each other, the results will astound you.