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Tuesday
Nov202007

It’s the Little Things

I experienced one of those close encounters with American health care today.

The day started off simply enough. I woke up. A little sore from yesterday’s workout. Rusty (the dog) was eager for me to walk to the store. I have long refused to get the paper delivered because the walk to the store (with Rusty) to get the paper prevents me from falling into absolute sloth.

Medicine is usually far from my mind, because I don’t like it. My feelings are summed up in musing about the peculiar phrase “third party”. I know one party in every sale is the “buyer”, the one who provides funds. This is, in most of the world, the insurance company or the government. I know the other party in a market is the “seller.” This is the name assigned the person who provides goods. In most markets the third party is someone who does not enjoy the benefit of the sale. At the butcher, the third party is (or was) a cow. In medicine, not being the primary buyer or seller, I suspect the third party is me.

But this morning I walked half way down the driveway, and then retreated to my room. I was introduced to the wonderful first person experience “Kidney Stone”. Ouch. I have always respected the pain of people describing kidney stones – now my respect is greater. In the realm of such things, I got of easy. I was done writhing before they began treatment at the local hospital. They provided me with a morphine drip to keep me occupied until they could produce a bill. I know several restaurants that could benefit from this approach to better manage customer reactions to the end-of-meal vanishing waiter.

But that’s not what I admired about this interaction.

In a process new (to me), my wrist-band name-tag included a raised-print name. Every test tube, every vial, was impressed with this simple tag before it left my bed. A simple process. A low-tech process. But a process that improved accuracy while reducing time. I liked it.

Two weeks ago, at Bechtel in Frederick, Md, I opined on what we could do with intelligent buildings. I was challenged; a professor of mechanical engineering came to my defense. “We know how to do all that. We’ve known for 20 years” he said. And he was right. More than doing new things, we need to bring the stuff we have already known how to do to the table. New technologies, and new system visibility, will help us to do so.

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