In 1937, the great American inventor and businessman Charles Kettering said, “It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.” My hunch is that if Mr. Kettering were alive today he would want to double down on that belief.
History is full of examples where that which was once universally accepted as the truth was eventually replaced with equal conviction of the exact opposite. In 1615, Galileo was placed under house arrest for writing that the earth circled around the sun. Today anyone alleging the opposite with conviction would be considered a lunatic.
In 1846, Ignaz Semmelweis, a physician from Vienna, was put in prison and eventually beaten to death after trying to
convince other physicians that patients were dying from infections due to physicians not washing their hands. Today physicians
who insisted on not washing their hands before and after touching patients would have a hard time finding employment
anywhere in the world. Up until 1982, every respected physician in the world was absolutely convinced the human
stomach had far too much acid for bacteria to survive. That is until pathologist Robin Warren showed that wasn’t true for
the bacteria H. Pylori which, by the way, also happened to be the cause of stomach ulcers. Warren won the Nobel Prize for
his discovery and has saved millions of people from suffering the pain and disability of stomach ulcers.
For those of you who are old enough to remember a rotary phone, how about these former beliefs:
• Japan will dominate the world during our lifetime due to its manufacturing and management prowess. (Today, the
Japanese stock market is about the same level it was in 1985.)
• The encyclopedia is the most important and reliable source of knowledge. (True, unless you consider this thing called
the Internet.)
• Every major city has one morning and one afternoon newspaper in addition to radio and television stations. (Raise
your hand if you were born after 1980 and have either read a printed newspaper or sat down to watch the evening news
in the last six months…I thought so.)
• High inflation is a permanent part of American economic culture. (Thanks, but we’d prefer a 2 percent mortgage over
a 16 percent mortgage.)
• And finally, medical doctors have it made. (I’ll let your mind run where it wants to with that one.)
Here are some things I thought were absolutely true until just recently:
Only a human could possibly win a game of Jeopardy! Not so much. IBM’s Watson, a question-answering computer using a
cluster of 90 servers with 2,880 processors and 16 terabytes of RAM, beat the all time Jeopardy! winner Ken Jennings.
Here’s another - health care providers are the only ones who can accurately diagnose illness. Who else, after all, can talk
to patients, examine them, review labs and imaging studies, think about a differential diagnosis and make a treatment plan
recommendation? Well, it turns out, the Cleveland Clinic, Sloane-Kettering and WellPoint all think Watson will eventually
be better than human providers, and they’ve invested their money in Watson to do so. After Watson has a query posed
that describes a patient’s symptoms and other related data, it reviews the patient’s health record for pertinent history, labs,
images, notes from other care providers, treatment guidelines, clinical studies, research materials and comparisons to other
similarly situated patients to come up with a differential diagnosis and treatment plan.
If all that seems like it’s a long way from Springfield, consider this: Mercy has worked with a company called Ayasdi to
review the data from our millions of patient records in Epic to come up with care paths for the diseases we most commonly
treat. The result? After the Ayasdi computers combed through millions of our data points, they have created treatment
plans based on a subset of all those patients who had the best outcomes under our care. The big question now is what will
we do with this new information?
Now, let’s add this. Today the Mercy Virtual Care Center (VCC) in St. Louis is remotely monitoring the care of many
patients who have multiple complicated medical conditions. Each of those patients has Bluetooth-enabled monitoring
equipment in their home for data like heart rate, temperature, respiratory rate, oxygenation, blood pressure, blood sugar
and weight, which is automatically uploaded into Epic and transmitted to providers at the VCC. When their results
start to fall out of line, these patients receive phone or video calls from VCC providers who put treatment plans in place
before an adverse event occurs.
Can you see where this is going? If, like me, you believed that the diagnosis and treatment of human illness was
squarely in the hands of other human beings…well, maybe what we know just ain’t so. We are in a time when many
things, formerly done by thinking human beings, can be reduced to a computer software algorithm, replaced by a robot
or outsourced to those who can do it better, faster and cheaper.
But before some of you get a sinking feeling in your gut and make predictions about the apocalypse, think about these
things: The biggest increases in the labor force have been in education and health services, which have doubled as a
percentage of total jobs since the 1970s. During that same time, employment in professional and business services was
up 80 percent and hospitality and leisure services are up 50 percent. Today, there is a clear trend toward more employment
in industries that value human interaction.
The trend toward thinking being done by computers while humans focus on social interaction is also clear. The
analytic skills of math and science are ever more susceptible to low cost competition and software. College graduates
with high cognitive skills are using those skills less. Since 2000, the amount of brainpower required of college graduates
has decreased and in 2012 reached the same level as 1980. Cognitive skills are still important, but those who use
their cognitive skills in addition to showing an ability to build relationships, brainstorm, collaborate and lead are in a
superb position to thrive.
We’ve evolved from the industrial era, to the knowledge era, to the relationship era. As people who’ve dedicated our
lives to the care of other people based on our ability to use our knowledge to form a caring relationship with them, this
should make us feel hopeful.
The fact is, change is inevitable. The way we do things, how we achieve our goals, even where we carry out our service
to others is going to change. Those changes don’t make us a victim, however. If we accept those changes, adapt
our thinking around those changes, create and maintain meaningful relationships with each other, as well as those we
serve, we become the masters of our fate. Although there is much we don’t know about our future, when we actively
engage in creating that future, there is a lot less to be fearful of, and a lot more to look forward to. Just think of what we
will do together.
