Adaptive Strategies Blog

My last post considered ways to think about the healthcare system and I offered five snippets addressing ways to think about the future of the health care system. The fourth of the five snippets was a simple statement to “think critically.” Easy to say; hard to do.

This is the first of eight posts that will take a deeper look at that simple piece of advice. Today I’ll provide an overview of seven components of critical thinking and in subsequent posts I’ll dig deeper into each of the components.

I’ve decided to focus on health care for a few reasons: (1) it’s REALLY important to a lot of people; (2) the “debate” has been highjacked by people (left and right) with very strong opinions who do not want us to actually think about healthcare, just follow their line of thought; and (3) I’m having a hard time getting my mental arms around this issue and feel that maybe a little writing will help me clarify my own position. I need your help here.

CRITICAL THINKING: It’s the process of figuring out what to believe and then what to do about your beliefs. It starts with “figuring out what to believe,” which takes time and is darn hard work. It’s easy to parrot a talk-show host; it’s uncomfortable to examine your own beliefs and figure out if they are built on a good foundation.

As you work on figuring out your beliefs, here are seven components of critical thinking to consider:  

• What’s the ISSUE and how does the issue look from various points of view. From a moral perspective do you believe that everyone has a right to quality healthcare? From a fiscal perspective, who should pay for this right? For that matter, what about our individual responsibility to live a healthy lifestyle. Should I pay for your smoking habit and should you pay because I like to eat a lot? Paying for the system has come front and center, but it’s not the only issue. Step One of critical thinking: get clarity about the set of issues and work at prioritizing them.
• What QUESTIONS bring clarity to the issues? And the most important question to ask is: Are we solving the real problems? With upwards of 90,000 people dying every year because of mistakes, misuses, and care-acquired illnesses, is the main issue about payment or quality? We have LOTS of smart people who can answer questions. Are we asking the right questions?
• What CONCEPTS are we using to organize our thinking? I’ve had healthcare executives (angrily) tell me that “We are not a factory making widgets!” True. But the concept of standardization seems to work in every other industry. Might it be applied to some of the issues affecting healthcare? Concepts help us organize our thinking and then explain it to others. What’s your concept of a hospital? (Remember, in the late 1700’s they were literally “a place to go to die.”)
• As we think about the health care system what are the ALTERNATIVES to today’s practices? The general hospital was right for medicine at the beginning of the 20^th century because it did everything for anybody. A hundred years later is it still the right way to deal with injury and sickness? For that matter, what are the alternatives to staying healthy and never having to use a hospital?
• ASSUMPTIONS are the foundation of all strategy and all plans. And when assumptions degrade, the plans are usually out of line with reality. What assumptions underpin the insurance industry? What assumptions are the foundation of the “medical home” concept being touted? What assumptions are employers making about their role in keeping employees healthy? What assumptions are you making about your health needs as you age?
• “Truth” often depends on your POINT OF VIEW. What does the system look like from the point of view of a retiree who is in the Medicare system? What does the system look like from the point of view of the owner of a small business? What about a self-employed bloke like me? Who’s right? All of us. Who’s wrong? All of us.
• As I write this all I know for sure is that Congress is going to do “something.” Not sure what it is; but I do know that whatever they do will have both intended and unintended CONSEQUENCES. People following an ideology tend to see the intended consequences of their actions and “get surprised” by the unintended consequences.  All of us should think about “what else” were getting when we take an action. It will play out – but later.

HELP!  I really want to get my arms around this and I need a conversation. Please comment – challenge – add-to – etc. Please pass this on to friends and colleagues who are in the system. What does it look like from the inside?

(Jodi, if you’re reading this it’s time to comment.)

OK, now it’s your turn.