Malcolm Gladwell, Part 2: Health Care Today

We recently posted on Malcolm Gladwell’s fascinating TED Talk on David and Goliath.  Today, we’d like to explore his thoughts on modern health care, along with a host of other topics.  He recently gave an online interview to One-on-One, with Medscape Editor-in-Chief Eric J. Topol, MD and in it he covers a broad range of topics, including:

-New drugs with $100,000+ cost per prescription.  He understands that that is an extreme amount of money, yet he argues that you can’t have it both ways:  you can’t ask for major, expensive research to be done to try and develop drugs to do significant things, like cure Hepatitis C, and not expect the drugs to then be expensive.  He suggests that there should be a correlation between what we pay and what we get back.  If a drug accomplishes a major task, it should cost a lot of money.

-How health care does a bad job of storytelling about itself.  The reality of medicine and the way the public thinks about medicine is growing farther and farther apart.   So many doctors are unhappy with their jobs –as workloads have shifted, status in society has changed, EMRs have been pushed on them, etc.  And yet, the public doesn’t see or understand this.  Most patients think that doctors wanted electronic medical records, that they would make life better for them, that they love their jobs and are paid well.  He described it as a classic story-telling breakdown.

-His career and how he developed his storytelling skills.  He credits it to a long apprenticeship of 10 years at the Washington Post. And, he studied other writers who he thought were better storytellers.  He also credits public speaking for greatly helping his writing.  He said the ability to hold someone’s attention in real time can force you to really up your storytelling game.

-His 10,000 hours philosophy.  He said that most likely what you know about it is wrong.  It’s not that if you do something for 10,000 hours you will become an expert at it.  It’s not just anyone doing something for 10,000 hours.  It’s someone who is already talented in a given area.  The person has to already be identified as having a skill or talent and then work hard at it.  In other words, you need discipline and hard work in addition to talent.  He goes on to say that finding talent is easy.  Finding talent and getting that person to work hard is not.

-Our educational system which asks young people to find and declare their careers at a very young age, with little experience.  He says it would be smarter to have someone in their late twenties to declare their job/career.  He wonders how efficient our society is at exploiting the pool of talent (in economic-speak, it’s called capitalization).  Currently, he says, we’re not good at it.

-Wasteful health care spending and what modern health care should look like.  He says he’s gone back and forth on this topic but he currently thinks there ought to be, at the bottom end, a cash economy.  He says we should be restricting insurance use and use it only for catastrophic events.  He also talks about how we don’t necessarily have to treat everything because we can.

-He also teases about his future book and research he’s doing.

For all of the details, and more, watch the video below:

http://www.medscape.com/viewarticle/847495