Category: General Medicine

Today you will see some patients.

Maybe the same ones you saw last month.

And probably for similar conditions because or your area or specialty.

You will be judged on how well you respond to their presenting complaint, particularly if you work in Accident and Emergency.

But imagine if you were paid to treat them BEFORE they showed up to see you?What would your day look like if you were putting out fires before they started?

Image: Hugh Macleod

“Go to work and do your job.”

That was the industrial revolution’s prescription for work in the last century.

Because in that era, your value was measured by your ability to conform to a pre-existing system…to be the best cog you could be.

But now in the 21st Century, the way our current Connection Economy rewards value has drastically changed.

We don’t need you to be a cog anymore, because we’ve now got robots, drones and AI neural Networks that can literally out-cog you 24hours a day, 7 days a week…for far less than you’re willing to work for.

But what the Connection Economy does need from you is to upgrade the software you’re running between your ears, and simply answer two questions every single day.

1. Who will you choose to lead today?
2. What problem are you going to solve today?

That’s it.

The quality of your answers to these 2 questions will be reflected in the value you receive.

And no, following orders or management don’t count.

What does count is the emotional labour of choosing to lead instead of just waiting to be told what to do.

What does count is daring to try something that might not work and might make you look like a fool, instead of just doing what you were trained to do, and being the fool who got replaced by a robot.

“How could you not have seen that coming?” your grandkids will ask you.

What does count is being willing to pick up the tools and opportunities that are outside the doorstep of the identity you’ve locked yourself into…and using them to make a difference.

And what does count is the mistakes you make because of your daily commitment to answering 2 questions:

Who are you going to lead…and what problem are you going to solve today?

This was one of the responses to the post about Upside down medical hierarchies:

Why would that sort of thing be needed? Of all the things to change in Medicine, not sure the hierarchy is one of them.

This comment reminded me of a line from James Clear’s book, Atomic Habits:

“…the only self-improvement strategy that makes any sense is to focus on what you can control.”

And one of the most important things we can control, is our willingness to try things that might not work, in pursuit of uncovering the breakthroughs that transform everything.

But alongside that is the reality that hierarchy is about deciding the rules of how the game is played.

No matter how well you think you can play the game, the real winner is whoever creates the rules of the game.

Hasbro has won every game of Monopoly ever played since 1991…because they are in control of how the game is played.

But relating this back to Medicine, experimenting with hierarchy is to experiment with how the game is played, rather than simply recruit more players to join the dysfunctional game that’s already being played.

How would it change things if a lower tier Medic had the chance to leapfrog a seasoned Medical consultant?

How could it change things if Junior Doctors got paid from a global healthcare blockchain based on their MedicRank, and not based on political clauses in “The Contract”?

What if you were paid to go to Medical School, but had to practice Medicine for free as a vocation?

What if the only people allowed to practice Medicine were those who were financially independent and didn’t need to be paid for their work as a Medic?

What if we rewarded Medics (Nurses, Pharmacists, Doctors etc) based on how much of their humanity they brought to each interaction with each patient?

“What if” questions like these are at the heart of reimagining how the game of Medicine could be played.

And experimenting with hierarchy could be just the thing that unlocks the brilliance and creativity of all the Medics who are being squandered by the current system.

What would happen if the hierarchies in Medicine operated like the Google search engine?

Right now, the hierarchies in Medicine look something like this:

Image: Hierarchy Structure

In other words, the more hours you put in, and the more you master the known field of Medicine, the higher up the ladder you will climb, attaining the much-coveted specialist consultant status.

It’s a typically linear “carrot-and-stick” progression.

But what if it weren’t?

What if it operated like Google, where each Medic was ranked on a combination of factors, where “years of experience” and “qualifications” were just one of many factors used in the MedicRank algorithm?

Things like:

• Reviews from patients
• Reviews and feedback from other Medics
• Number of articles/papers published
• Projects and innovations launched
• Disease Zero teams participated in
• Innovations developed
• Open source platforms contributed to
• Number of referrals made
• Number of Medics collaborated with

What if you didn’t have to wait to be licensed by the General Medical Council in order to receive a MedicRank?

What if a 1st year Nursing student or Internal medicine resident or lab technician had the opportunity to achieve a higher MedicRank than a Consultant Neurosurgeon with 35 years experience?

What if every Medic got paid by a global healthcare Block chain in proportion to their MedicRank?

What if Medics tried to “game the system”…trying to boost their MedicRank in the same way that websites tried to hack their way to the front page of Google?

There are probably many reasons why we “can’t” do this/why this is “completely unrealistic”.

But what if this is the future of 21st century healthcare?

What if this became your reality 3 years from now?

How would that change what you do for the rest of this year?

What would happen if the hierarchies in Medicine operated like the Google search engine?

Right now, the hierarchies in Medicine look something like this:

Image: Hierarchy Structure

In other words, the more hours you put in, and the more you master the known field of Medicine, the higher up the ladder you will climb, attaining the much-coveted specialist consultant status.

It’s a typically linear “carrot-and-stick” progression.

But what if it weren’t?

What if it operated like Google, where each Medic was ranked on a combination of factors, where “years of experience” and “qualifications” were just one of many factors used in the MedicRank algorithm?

Things like:

• Reviews from patients
• Reviews and feedback from other Medics
• Number of articles/papers published
• Projects and innovations launched
• Disease Zero teams participated in
• Innovations developed
• Open source platforms contributed to
• Number of referrals made
• Number of Medics collaborated with

What if you didn’t have to wait to be licensed by the General Medical Council in order to receive a MedicRank?

What if a 1st year Nursing student or Internal medicine resident or lab technician had the opportunity to achieve a higher MedicRank than a Consultant Neurosurgeon with 35 years experience?

What if every Medic got paid by a global healthcare Block chain in proportion to their MedicRank?

What if Medics tried to “game the system”…trying to boost their MedicRank in the same way that websites tried to hack their way to the front page of Google?

There are probably many reasons why we “can’t” do this/why this is “completely unrealistic”.

But what if this is the future of 21st century healthcare?

What if this became your reality 3 years from now?

How would that change what you do for the rest of this year?

What would happen if the hierarchies in Medicine operated like the Google search engine?

Right now, the hierarchies in Medicine look something like this:

Image: Hierarchy Structure

In other words, the more hours you put in, and the more you master the known field of Medicine, the higher up the ladder you will climb, attaining the much-coveted specialist consultant status.

It’s a typically linear “carrot-and-stick” progression.

But what if it weren’t?

What if it operated like Google, where each Medic was ranked on a combination of factors, where “years of experience” and “qualifications” were just one of many factors used in the MedicRank algorithm?

Things like:

• Reviews from patients
• Reviews and feedback from other Medics
• Number of articles/papers published
• Projects and innovations launched
• Disease Zero teams participated in
• Innovations developed
• Open source platforms contributed to
• Number of referrals made
• Number of Medics collaborated with

What if you didn’t have to wait to be licensed by the General Medical Council in order to receive a MedicRank?

What if a 1st year Nursing student or Internal medicine resident or lab technician had the opportunity to achieve a higher MedicRank than a Consultant Neurosurgeon with 35 years experience?

What if every Medic got paid by a global healthcare Block chain in proportion to their MedicRank?

What if Medics tried to “game the system”…trying to boost their MedicRank in the same way that websites tried to hack their way to the front page of Google?

There are probably many reasons why we “can’t” do this/why this is “completely unrealistic”.

But what if this is the future of 21st century healthcare?

What if this became your reality 3 years from now?How would that change what you do for the rest of this year?