Wednesday, June 13, 2012
Fitness maven Jeanette Jenkins recently tweeted that “to see big results you have to get comfortable with being uncomfortable.” In other words, making change happen, inevitably leads to emotional or physical discomfort. If you are serious about change you must be willing to endure a lot of discomfort. While this is no doubt true, I would take things one or maybe two steps further and say “Disruptive change will only happen when you become uncomfortable with being comfortable”! Yes, change is almost always hard. But not all change is sufficient, significant nor even good! There is probably no better example of this than in healthcare. Over the past decade there has been a significant amount of work done to understand healthcare disparities. This work has led to a lot of change (practice, interventions, policy, pharmacology) in many areas (Social Determinants of Health, Cultural Competency, Community Partnerships, Community Based Participatory Research, Environmental Health, Populomics, Big Data Science etc…) that took a lot of effort, on the part of many people to achieve, and the progress continues. Yet, as we look across our nation, as the latest volume of the National Health Care Disparities Report indicates, there has been no significant, sustained improvement in any disparity in almost a decade! Similarly, a huge amount of effort at many levels is occurring around the notion of bringing our healthcare system into the digital age through notions of Personalized Medicine, Genomics and more recently Health Information technology (clinical decision support tools, Consumer Health Informatics tools, Health Information Exchange). As with the previous example, much effort along these lines, has resulted in much change in many areas, however the hypothesized and potential impact of drastically improved healthcare processes and outcomes, particularly at the population level, have not been realized. While it can be credibly argued that we are just at the beginning of innovation curve in both these areas (as such it would be impossible to see significant change yet), I believe this is not the primary reason keeping disruptive improvements from happening. I believe this because when you study change, the type of large, life altering change that is so significant, the results could not have been predicted at the outset – so called disruptive change (iPhone, PC, Internet) – it rarely occurs as the end product of incremental improvements over time. Rather, the innovators, inventors, physicians, entrepreneurs or visionaries simply refused to be satisfied with the then current norms or absolutely relentlessly sought solutions to challenges that most others considered impossible. In other words they became uncomfortable with accepting the status quo or reaping the comforts that the status quo afforded, even though others may not be able to receive the same benefits. They became driven by the pursuit of one thing, not just change, not only improvements, not financial gain, but rather large scale solutions and wide spread problem elimination! They pursued these goals often in the face of constant criticism, in spite of the “conventional wisdom” and even against the realities of their own past experience! They remained focused on the notion that societal solutions or personal triumph over failure was achievable…period! Whether the goal is personal weight loss, professional achievement, disparities elimination, patient access to personal health data, societal health improvement, or global peace, resist the logical, evidence based tendency to be satisfied with “change”, and release yourself to achieve what others think impossible by first becoming uncomfortable with being comfortable!