Being goal oriented is a popular virtue these days. There are innumerable websites promoting all sorts of methods to increase productivity, wealth, heBeing goal oriented is a popular virtue these days. There are innumerable websites promoting all sorts of methods to increase productivity, wealth, health, happiness, and so much more. The sometimes unstated, but more often over-stated, message of many of these resources is that we need to sit down, clearly define our goal, and march directly towards it.
Our failure to achieve these goals is then attributed to our lack of focus, lack of drive, lack of persistence. But, what if our real failure is related to our attempt to achieve our goals directly? What if we shifted our focus away from our ultimate goals? Perhaps we would have better success in achieving them.
This seemingly counter-intuitive idea is the subject of John Kay's very interesting book Obliquity. To see what he is getting at let's take a look at some examples of important goals best achieved indirectly.
Happiness: Everyone is striving to be happy. But, studies have shown that the happiest people are the ones who are the least focused on this goal. Those who are most happy with their own lives tend to be ones focused on helping others to be happy. Or they are focused on achieving some other goal whether it be performing a task well, completing a project, raising a child, creating a piece of art. By focusing on other things they end up being happy. In fact, they end up happier than they would have been had happiness been their direct goal.
Wealth: I have a few students every semester who tell me that their goal is to be wealthy. But, they are often dumbfounded when I point out that most wealthy people do not focus on becoming wealthy. Instead, they focus on doing something well, running a company, making a product, serving other people. They pursue these goals with drive and passion. Often with an obsessive rigor. As a result, they end up wealthy. As Kay points out, the most profitable companies are not profit driven.
Social Order: One of the most intriguing passages in Adam Smith's The Wealth of Nations describes the possibility of arriving at social order by focusing on individual self-interest: "By pursuing his own interest he frequently promotes that of society more effectually than when he really intends to promote it." Leaders would do well to remember this insight as many of the problems created by leaders of companies and countries are the result of attempting to promote direct solutions to problems which would be better solved by indirect solutions.
To understand these examples we have to be willing to recognize the limits of our own knowledge, the biases in our own thinking, and the possibility that these too can be overcome not directly but by being indirectly addressed. Direct solutions work well on straightforward problems where all the information needed is known. But, in a world where individual knowledge is often incomplete and imperfect our best recourse is to oblique solutions.
The ultimate example of obliquity is the example of the diversity of life that is all around us and how that diversity arose. In formulating the theory of evolution through natural selection, both Darwin and Wallace recognized the insight that this diversity was driven indirectly. Order could result from disorderly processes working with a healthy dose of randomness. This theory still confounds many today precisely because it is based on the insight that obliquity is a powerful force at work in the world.
We need to embrace the insight and the uncertainty that comes with it. If you're concerned about your own happiness, your own wealth, your own success, your own love life, try focusing on something else. Try helping someone else. Try serving others in some useful way. And, without intending it you will achieve your goals. Indirectly with obliquity....more
Disruptive innovation is coming to higher education and this book provides the roadmap. Much of the technology is currently in place and many studentsDisruptive innovation is coming to higher education and this book provides the roadmap. Much of the technology is currently in place and many students are beginning to take advantage. But, the full implementation of what Kevin Carey calls the University of Everywhere will take time.
Imagine being able to learn what you want, when you want at virtually no cost. Imagine getting a quality education without having to go thousands or hundreds of thousands of dollars in debt. That is what the University of Everywhere will entail. No, this isn't just cheer leading for massive open online courses (MOOCs) though they will have a part to play.
No, this is about freeing knowledge and access to knowledge and about life long learning. While the technology for the online portion of this is well developed one important barrier remains to be addressed which is credentialing. At this point universities and colleges are able to charge expensive tuition for the official accredited credentials that students seek. But, with platforms like Mozilla's Open Badges this too will change. At some point in the not too distant future you will be able to learn and document your learning easily and with little financial commitment. And, you will own both your learning and the documented evidence of it. Just as in health care where the trend is moving towards patient's owning their own health date, so too in education the trend will be towards individuals owning their own transcripts as opposed to universities owning them.
A common feature of industries in the midst of disruptive innovation is denial. Predictably many are continuing to express denial that there are any massive changes coming to higher education or that these changes will affect them or their institutions directly. Many colleges and universities will be slow to see these changes coming and will not adapt well to them. Others will take tentative steps toward adaptation. The question will be whether these steps will be too little too late.
The precise timetable for these disruptions is impossible to predict. It could take another generation or it could happen quicker. But, one way or the other there will be disruptions. It is inevitable. Inevitable because the knowledge that universities are currently charging for mostly available elsewhere for free. Once the credentials are also available and employers begin using them as indicators of skills and hiring based on them there will be little left for many colleges to do.
The universities and colleges that survive will do so by being remarkable. They will adapt by offering services their students want and need whether these are directly related to their mission or not. They will survive by being flexible and open to experimentation. Unfortunately, the higher education system is not well equipped to be adaptive or flexible in this way.
Carey has given a comprehensive argument for how change will unfold and should be regarded by colleges and universities as a call to take action now in order to survive and even thrive in the midst of massive change. Will they take this opportunity or remain in denial?...more
Eric Topol's newest book provides a thorough overview of many of the recent advancements in health care delivery which will surely cause massive disruEric Topol's newest book provides a thorough overview of many of the recent advancements in health care delivery which will surely cause massive disruption in the way health care is administered in the U.S.
Reading the book inspires me to make some connections to other areas which are, or soon will be, similarly disrupted. In particular, as an educator I see many parallels with the changes underway especially in higher education.
The same advances in technology will have some of the same effects on the institutions and those working in them whether they are physicians or professors.
Consider first the title of the book itself. In the not-so-distant future patients will have greater power over the relationship they have with health care providers. Slowly, the grip of medical paternalism will give way under the pressure of new low-cost technology. With so many other options for accessing health information and care, patients will benefit. And, many doctors will lose patients. Patients will have more choices and will demand that when they see their physician the experience be worth their time. For those physicians who aren't, the patient will certainly not see them.
If the patient gains more control over when and under what circumstances they will choose to see a doctor, that means only the best doctors will prosper. Only those willing to listen to their patients, really help them, address the root causes of their problems, and work to improve their overall health as opposed to simply managing symptoms.
To use Seth Godin's word, the physicians who will thrive in this environment will need to be "remarkable." Many physicians are not. What will happen to them? They will, and should be, disrupted right out of practice. So much the better for their patients.
As Topol points out in the book, we now have the technology to perform many parts of the routine physical via a patient's smartphone. The movement towards greater patient control will also include a shift from health care providers controlling patient data to patients taking ownership of their data. The patient will be able to monitor their own health stats, control their own data, test results, and other important information. Of course, that will mean more patient responsibility as well.
Needless to say, many health care providers will fight these changes because they ultimately mean the end of paternalism and many lucrative careers. And, as in other industries which are being disrupted like education, many will remain in denial about the coming changes in health care. Others will be slow to see the trend and get out in front of it. That will mean a lot of needless disruption to patients as practices scramble to keep up or stay afloat.
I would love to see those in the health care industry working to move these changes forward and adapt to them in ways that will benefit patients. Stop spending your time defending the status quo and start asking what you can do to improve patient care and patient health. Take the initiative to offer patients control over the medical records and test results. Find ways to work around needless bureaucratic impediments that will ultimately be overcome and streamline the patient experience.
There will always be a need for patients to see physicians in person at least for some health care needs. So, health care providers need to work to make these visits remarkable. Start with the presumption that you owe the patient their FULL visit time. Listen and find ways to document without sacrificing this listening time. Commit to seeing every patient, on time, every time. You think that can't be done? Ask why you think this and make the changes necessary to make this happen. Patients used to have to put up with this. Not for much longer. The patient will see you now, but only if you merit being seen. With so many other options available for their health care you will only be chosen if you do what most are unwilling to do. Be available. Be a resource for patient health. Be a partner in the patient's overall goal of good health. Do more than a smartphone app can do otherwise you will be replaced by that app....more