Medicine has been plagued with the issue of logic. If A = B, and B = C, then does A = C? The answer unfortunately is not always yes.
As we look at the science behind a lot of what we do, we first have observational studies that tell us something. For example, in the field of high cholesterol, an observation is those with high HDL levels have lower risk of heart disease than those with lower levels of HDL. We also have drugs that can raise HDL, and therefore we jump to the conclusion that if we raise HDL with said drug, then we can lower the risk of heart disease. Time and time again, this line of logic has turned out to be false. Using this example, a study might not show that raising HDL with said drug will decrease the risk of heart disease. Recent data is showing that just lowering HgbA1c in diabetics is falling under the same scrutiny.
My point is not that we should stop treating things, or that we are wrong for making assumptions, but that we need to make sure we do not fall in love with the solution and instead always fall in love with the problem. Whether in treating medicine or coming up with a new innovation, we must remember we are trying to solve a problem first, and everything we do needs to be tested against that fact. Sure, we will need to make assumptions and do things based upon them, but the key is to test those assumptions. The problem described above is, “How do we lower heart disease?” not “How do I raise HDL?”
We see this play out in so many different areas of healthcare other than just drug treatment. Technology is one where we seem to fall in love with the tool being demonstrated. When we do that, we begin to try to find a problem to fix with the solution we are viewing instead of the other way around. Technology is just a tool to help us fix a problem. We must first make sure we have the problem identified and know how we want to implement a solution, and then find the technological tool that will help. Many call this type of situation the “shiny object” syndrome, when we are walking along and see a shiny object and say, “I have to have it,” even though it completely detracts me from my path.
If we truly want to deliver value to those we serve, and we want to be in true partnership, we have to check our assumptions and human tendencies at the door. We need to remain steadfast to the problem we are solving and not be sidetracked by flashing neon along the way. We need to make assumptions and implement solutions, but it is paramount we test them. We need to use technology to help us as we solve the problems, but not let technology define the problem. We need to always remember that being wrong is really the best way to learn.