Friday, June 2, 2023

I think a concept that people find confusing is the idea of deflationary forces in an economy. While it has a negative connotation, it is highly context-dependent. For example: is high blood pressure bad? Yes, over many months to years, if measured while you're sleeping. Not if you're running from a tiger. Is Gatorade good? Maybe, during a triathlon. Probably not as part of a daily workout routine.

Everything depends on context, and all that I'll address in this post is the idea of deflation and its impact on technology as it relates to medicine. It's just a brief starting point, because it's a valuable concept to grasp and apply.

Deflation is a naturally-occurring decline in prices of goods and services as efficiencies, often due to technology, increase abundance of supply. The result: one dollar buys more today than it did last year. Think of how many more movies you can access with 15 dollars on Netflix than you could in a Blockbuster retail store in 1995. Same goes for medical knowledge. The price of the knowledge has plummeted. Of course, anyone can learn medicine, but not everyone can practice medicine. Let's set aside any discussions about artificial forces of market intervention for now (yup let's just ignore that adorable elephant in the corner).

I have always cared more about seeing people live healthier through better health literacy. It was how I started my career: first as a diabetic educator, then medical school. People think I'm joking when I say I'd rather be out of a job and go surf with my healthy patients than to make a few hundred thousand dollars a year rounding on them as a hospitalist, but I'm not.

Obviously we still need hospitalists and hospitals, but it's good food for thought. The knowledge to understand and prevent disease is becoming more accessible and therefore cheaper for all consumers, but I think we have yet to feel a palpable impact on the actual thing that matters: value. Maybe it’s our high expectations as consumers, myself included.

The value of health care in most scenarios is subjective, excluding obvious examples like a broken bone, resectable cancer, or curable infections. These are the things that medicine was designed for. Today, value is relative based on your geography, aesthetic preference, cultural values, level of impatience, level of tolerance for discomfort. It's such a privilege and yet such a curse that we have this degree of choice, and these murky "medical decisions" have convoluted the structures that govern pricing of even straightforward diagnoses.

If medicine were still just about simple pneumonias and broken bones (like 1930s medicine), then of course deflation would be a very obvious and simple effect. Super cheap if everything about medical care has remained constant. So the question for reflection is: in what ways, good and bad, has our industry changed in the last century through technology that has inflated, rather than deflated, the cost of goods and services that is "health care?" in America?

Thursday, June 1, 2023

We focus a lot on all the problems in health care. There certainly are. From medical disparities to unsolved diseases to preventable tragedies. But it's important to focus on all the progress we've made and the resources that are available to us, even over the course of our short lifetimes.

Technology, despite its tendency to polarize and frustrate initially, has served one undeniable function: to make information and insights more accessible to people.

I recently have been discussing basic health maintenance with family and friends and it's clear that medical literacy has made massive progress in under a decade. Sure, there is misinformation out there that must be battled. But for the people out there who are using blood pressure cuffs to understand the impact of diet and meds on their health, chat GPT (and even WebMD) to understand the difference between lactose allergy and intolerance, and smart watches to optimize their workout / recovery / sleep regimen, I embrace you and encourage your dedication to discovery and pursuit of signal in an inevitably noisy world.