Collaborative Clinical Practice: The Resistance to Fixation
“A way of seeing is a way of not seeing.” -Poggi, 1965
Dr. Clay Shirky, an insightful thinker on technology and its effects on business and society recently sat down with Radar and spoke about the effects of low cost coordination and group action as well as where to find the next layer of value when many professions are being disrupted by the Internet. Even more, Dr. Shirky’s interview sheds much light on clinical practice and collaborative encounters.
Dr. Skirky emphasized the importance of rethinking many of our current business and healthcare models as a way to invent tasks, technologies, and training in ways that we didn’t think could happen. Although he didn’t explicitly use these words, his concern with re-working many of our current models or ways of thinking is essentially a resistance to fixation. That is, a shift away from making decisions based on logics that are flawed or outdated and instead embracing a state of indeterminacy where those who are learning and adapting in times of transition will be most productive. Start imagining! Even more, start asking questions about the questionability of many of the models and logics we often hold dear to our hearts about how patients should be treated; how research should be designed; how curricula should be created; how decisions get made; how Internet searches can link people to opportunities and how we can un-learn models through collective action so they may be re-organized through a sense of accountability and action. Again, start imagining!
Dr. Ken Cohn recently discussed the book What Top-Performing Organizations Know: 7 Proven Steps for Accelerating and Achieving Change (Butler & Cladwell, 2009), which is written as a “survival guide” for senior healthcare executives and middle managers. The book makes the argument that organizational success is contingent on how transformational initiatives are organized for accountability and action. According to the authors, “structure drives culture as much as culture drives structure.” Furthermore, the book includes processes that prove reliable in organizing healthcare professionals for change and creating a culture of action and accountability. Dr. Shirky, too, described this as less of a technological shift and more of a cultural shift. But these have become buzzwords that in fact carry much weight and are rarely defined. Although definitions can be helpful, they also can be burdensome by providing rigid boundaries. Dr. Shirky, however, encourages us to not focus on model a or b; rather models a –z which essentially asks not what would a culture change look like but what are we able to do, what are we able to say and what are we able to achieve using this model versus another. His sensemaking is active and in so doing emphasizes community and its emergent character.
Finally, as Nina Zagat gets underway invading a new and even trickier reviewing niche – doctors – wouldn’t it make better sense to ask (and rate) not what patients think of doctors but, how well each party does to open up such a conversation so that they can collaborate about patient care and overcome outdated models of how clinical care is produced? There are many online communities who are attempting to do just this: get people talking in new ways about important things. Online communities and start-ups can be risky but as Thomas Friedman recently noted – “necessity makes innovators even more inventive and risk-takers even more daring.” So let creative destruction happen so that the health arena may thrive instead of just survive with new and innovative models.
Thanks to cobalt123 and ronnie44052 for their captivating images!
Looking forward to hearing your thoughts…
Carey Candrian
Tags: Clay Skirky, clinical care, clinical guidelines, collaborative clinical practice, collaborative encounters, community health models, community models, Dr. Ken Cohen, health 2.0, healthcare collaboration, healthcare models, innovative technologies, Nina Zagat, online communities, online community, online innovators, professionals, Radar, start-ups, the professionals, Thomas Friedman
