This series has been about the underlying reasons why healthcare cost is out of control while quality underperforms expectation. As noted many times, our expensive system is the result of how we have viewed the problem. Moreover, when we come to believe things work in a particular way, it is very hard to see anything else. In one of his routines, the late comedian George Carlin coined the phrase “vuja de.” It is the opposite of “deja vu” in that it involves seeing the same thing repeatedly and then suddenly experiencing a completely different understanding. In healthcare, we have been working from the same playbook for decades. We are uncomfortably comfortable with it and believe that, with all its flaws and failings, it is acceptable. Even though the financial bottom line gets worse every year, we find solace in its apparent logic and the myriad of activities that continue to show improving but unproductive Vanity Metrics related to internal processes. This was my model, too, until Bart McMullin connected what I already knew about Complex Adaptive Systems with the lack of progress in moving healthcare’s bottom line in a healthy direction. And I am not alone. All across this country, there is a growing awareness that the model of the Complex Adaptive System (CAS) is a better fit for healthcare.
[For more of this story, written by Michael Rohwer, go to https://www.thelundreport.org/...%80%94if-we-act-soon]
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