Category: General Medicine
You can’t find these things in Africa
We had a lecture on Monogenetics this afternoon and looked at some genetic conditions present in Uganda. Conditions like:
- Thalassemia
- Sickle cell anaemia
- Haemophilia
- Tay Sachs Disease
- Huntington’s disease
The lecture was dragging a bit so I engaged the lecturer by asking some questions about how we could solve these problems forever.
And I asked what it would take to be able to do genetic screening on every newborn baby…as well as to do gene therapy on adults.
The question seemed to strike a nerve and the lecturer proceeded to detail how expensive the smallest possibility of doing this would be.
“Just one vial of primer for genotyping would cost $800…just to do part of the screening.”
And then after painting a doom and gloom picture, it culminated with the phrase:
“You can’t find these things in Africa.”
Henry Ford said: the person who thinks it can’t be done and the person who thinks it can are both right.
And all the breakthroughs in society are the result of a heretic daring to take someone’s ceiling as a floor for building the next discovery on.
I believe that many of the problems in Africa aren’t as impossible or hopeless as they’re made out to be.
The hopelessness narrative serves the purpose of generating sympathy (and donations) to fund the various NGOs on the ground.
But when you view them as simply problems to be solved, they’re no different from problems like:
- Making cars easily affordable at great scale (Henry Ford)
- Getting a heavier-than-air vehicle to fly without crashing (The Wright Brothers)
- Inventing a bulletproof vest (Stephanie Kwolek)
- Defining the theory of radioactivity (Marie Curie)
- Equality between blacks and whites in the USA (Martin Luther King Jr)
- Putting a computer on every desktop in the world (Bill Gates)
- Organising all the world’s information (Larry Page and Sergey Brin)
- Growing a baby outside of the body (Patrick Steptoe and Robert Edwards
Not to mention (in no order whatsoever): The Internet, overnight shipping, driverless cars, polio vaccine, seedless grapes, oral contraception, virtual reality glasses, the pancake…
All of these innovations – big and microcosmal – are simply successful attempts at developing problems to solutions.
And the problems in medicine aren’t the problems. But rather the Mindset that views them as “unsolvable”.
That’s one of the biggest issues I’ve found in my time dealing with medical schools over the last 18 years.
Students are trained to diagnose and manage rather than empowered and provoked to solve problems.
Management is an important part of solving the problem. But in practice, it becomes the end, rather than a means to support the end of completely solving the problem.
And when it comes to the so-called “that’s life in Africa” problems, this mindset of problem solving is a vital asset to cultivate.
So to make this practical…and not just a rant…my challenge is to outline some of the top high impact problems in healthcare…and see if I can articulate the solution that’s needed.
And if the solution is just “money”, then that’s another problem that is quite simple to solve.
Africa has the potential to be the healthiest, most prosperous and peaceful continent on the planet.
And an important step towards realising this potential is to ditch the “not in Africa” narrative when it comes to conceiving solutions.
All things are possible…especially in Africa.
Image: oecd.org
Disrupt your personal narrative
Anatomy, physiology, biochemistry, pharmacology, pathology, microbiology, epidemiology…
Surgery, paediatrics, geriatrics, obs and gynae, orthopaedics…
First year, second year, third year, fourth year, fifth year, internship, rotations, specialisation…
PLEB, USMLE, Fellowship, Part 1, Part 2, Masters, Diploma…
Now imagine all of this being replaced by a 9 year old with a smartphone.
Imagine all of these formidable bits of paper achievements being as relevant as a greasy newspaper used to wrap up last week’s fish and chips.
Imagine a world where a Doctor isn’t a person…but rather an interconnected network of trillions of devices all focused on annihilating and anticipating threats to the homeostasis of global (and individual) health.
Imagine that everything you’ve been using to define your personal narrative…suddenly vanished overnight, leaving you with one question:
Now what?
These were some of the ideas I was exploring in class today with one of the students who was asking me to give him advice about what he should do.
I think regardless of where you are, the practice of disrupting your own personal narrative is no longer an option.
Because all the changes that are happening right now are asking you whether you’re going to disrupt your personal narrative…or if you’d rather that someone else did it for you.
An important reminder for myself as I battle again with 2nd year basic sciences after a 15+ year hiatus.
I feel that Medicine is in the middle of being completely overturned.
And my goal is to use this blog to document and anticipate these changes…as well as to share my ideas regarding the Okay Doctor healthcare system.
But more than that, the act of committing to shipping out a new idea every day is a way of disrupting my personal narrative…instead of having it done for me.
Look like a Medic, think like a startup
Reflections on the Kiyosaki quadrants.
Looks like a Medic, thinks like an Employee…waiting to receive orders.
Looks like a Medic, thinks like the Self-Employed…tries to solve every problem by trading time for money. Locums/freelancers fall into this category.
Looks like a Medic, thinks like a Startup…uses Systems, Networks, OPM, OPT, and Investors to find profitable solutions to painful problems that the marketplace is willing to pay for.
Which are you? Why?
What would happen if you thought and acted like a Startup?
Read the numbers
It’s important to record the numbers, but crucially important that you know how to read the numbers.
What story are they telling…and what actions do you need to take in response to that story?
Are you positive or not?
When it comes to HIV, Hep B, Hep C etc, hopefully the answer is negative.
But when it comes to your cash flow, I hope the answer is positive.
Are your assets paying for your liabilities? Do you know the difference between the two? If you stopped working today, could you maintain your current standard of living for at least 6 months?
These are questions you need to be able to answer by being cash flow positive.
Unfortunately, most Medics have bought into the Debt-Funded scam.
They go into debt to fund their medical studies so that they can get a well-paying job that pays back the debt and earns them a good living whilst letting them make a difference in the world.
The problem is that “the borrower is servant to the lender”. And the position of being Debt-funded compromises your ability to make clear, unbiased decisions from a position of power and leverage.
So when the health care system decides not to pay you…that affects you.
And when the system you’re working in is clearly broken, you don’t challenge it, because you need to get through it to pay off the loans that are funding your studies.
Now whether or not this is an intentional Conspiracy-type ploy to control the Medics is not the issue.
The issue is that Debt-funded, negative Cash flow Medics are easier to control than their positive Cash flow counterparts.
So as inconsequential as it might seem, check your Cash flow and spend 10 minutes checking your financial literacy.
4 hours a week?
4 hours a week
80 to 90 hours per week.
That’s the typical workload of a Doctor…and a huge factor in the on-going 21+ day-strike of all government Doctors in Kenya since 5th December 2016.
Overworked, underpaid, and unappreciated work, as the Doctor nobly fights to save each patient he or she comes across.
But what if instead of 90 hours a week…The Doctor worked only 4hours?
4 hours a week?
What would happen if that were the case?
What would the world look like where every Doctor only worked 4 hours per week in practising the craft of Medicine?
What would the implications be? Economically, socially, culturally, politically…personally?
How can a Doctor work fewer hours and achieve a much greater impact?
Just some of the questions I’ll be exploring in my new Medium.com publication: The 4-Hour Medic
I’m importing the Tim Ferriss 4-Hour Work Week meme into the world of medicine to see what breakthroughs it can help unlock.
Maybe nothing. After all, this might not work.
Or maybe it will spark just a single conversation…a single idea…that leads to a breakthrough that changes the face of Medicine and health care for the next 2,000 years.
That’s the goal. Let’s see what happens.