It is a common stoic belief that through pain and suffering we become idealized versions of ourselves, that the forge of fire creates the steel of strength.
While the ancient stoics intended this analogy to apply to human development, in current day, we can apply to it modern healthcare just as well.
As healthcare emerges from a year of lockdowns, isolations, and deaths, it is understandable for many to simply wish to move on, forget the past and continue pushing forward.
This would be a mistake.
Because the pandemic has made apparent what was always present in healthcare. The foundational rifts within healthcare exposed by the pandemic should not be glossed over with the sheen of ignorance. Rather, we should take this opportunity to learn all the lessons from the pandemic.
Not only the overt lessons of viral epidemiology, but the basic lessons intrinsic to healthcare itself. Ann Rynd wrote that we must not conflate circumstantial knowledge for foundational knowledge, implying that we must avoid looking at a situation and inferring all there is to know from what is immediately obvious.
The pandemic was not an ordinary event in healthcare, it was a once in a lifetime event, the effects of which we have yet to fully understand.
In the past, when such pandemics or global healthcare crises occurred, we responded in dramatic, diametric ways – but responding only to the most obvious culprits. After the Cholera pandemic we initiated public sanitation programs throughout the country. After the Great Influenza epidemic we created vaccines for some of the most severe viral and bacterial infections.
And the effects of which reverberate to this day. We have health commissioners in every city and state overseeing public health efforts and ensuring standards of care are maintained in healthcare facilities within their jurisdictions. We have children inoculated through a scheduled series of vaccines that essentially defines the childhood healthcare experience.
All of which are reactions to these earlier healthcare pandemics and crises. But in reacting, we address only the specific circumstances unique to what transpired. We do not address the more foundational issues.
This is why the same pandemic deniers that roamed about during the Great Influenza epidemic once again reared their heads during the COVID-19 pandemic. And why vaccine hesitancy is an issue we cannot seem to overcome in America, no matter how many diseases we overcome through preemptive inoculations.
In reacting, we fail to understand the ultimate causes, the foundational issues, in healthcare. Instead we focus on the most obvious solutions to the most overt presentations of the same, recurring problems.
We should not repeat this mistake.
We should instead look at the pandemic for what is truly was – a symptom of the many issues ailing healthcare in America.
Yes the pandemic was a viral outbreak. But it was also an indictment on the public perception of healthcare, and the role of trust and credibility play in following healthcare guidelines.
Data matters less than the perception of data. And healthcare is more of an art than a pure science. In which the art of communication and implicit perceptions of trust matter just as much as the physiology of viral inflammatory pathways.
In previous instances, we conflated reactionary responses as true solutions. While that has done some to advance the needle of healthcare, it has failed to address the same issues we find reverberating in nearly every pandemic or crisis.
The foundational nature through which patients interact with their health, and how that interaction impacts the way the public as a whole views healthcare at large.
This is not an issue that can be solved through traditional clinical means or existing public policy strategies. It requires a foundational shift in how we perceive healthcare.
Albert Einstein said, “we can’t solve problems by using the same kind of thinking we used when we created them”. We cannot use the same pre-pandemic approaches to solving the foundational problems in healthcare that were exposed through the pandemic.
And if we truly wish to use the pandemic as the impetus to extract meaningful change in healthcare, then we must resist the temptation to focus on the most overt, simplest solutions. We must focus on the patterns of thought that perpetuated and exacerbated the pandemic. The cacophony of conflicting views that defined our outlook on mask wearing or social distancing, conflating medical guidance with personal liberties.
These are the foundational issues that will truly advance healthcare. Issues that have been made glaringly evident in the minds of the public – creating a unique opportunity to address them while they remain relevant in public discourse.
An opportunity that can only come about if we are willing to go through the pain and suffering required to address these issues head on.
The problem is that most are not willing to endure the fire.
Opioid epidemic in one chart – correlation conflated with causation
There is no cause-and-effect relationship between prescribing and overdose mortality. But millions of patients are being denied safe and effective pain care.
Seniors over age 62 are prescribed opioids for pain three times more often than youth under age 19. But youth have overdose rates three times higher than seniors. No medical model can explain these demographics.
Source: Richard A Lawhern, PhD, Patient Advocate