An Ohio physician-blogger has become embroiled in a scrap with a national health policy expert over a much-discussed Harvard Medical School commencement speech by Atul Gawande.
Dr. Jeffrey Parks, who blogs at Buckeye Surgeon, raised the ire of policy wonk Maggie Mahar with his dismissive comments on the speech, in which Gawande, a surgeon, journalist and author of “The Checklist Manifesto,” emphasized that future doctors will do far more of their work in teams than alone. The speech is certainly worth checking out, but the title conveys the contrast Gawande draws between doctors of the past and future: “Cowboys and Pit Crews.”
Parks thought that wasn’t exactly the most inspiring message Gawande could give to recent grads, and mocked Gawande by summarizing the speech’s theme this way:
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Small practices play a critical role in healthcare delivery, but they cannot continue to absorb ever-increasing administrative demands without consequences.
Healthcare is far too complex for any one doctor anymore. So gear up to be an interchangeable part, a faceless drone who performs menial tasks according to checklists and algorithms that Really Smart People will provide for you.
Parks likely drew the attention of Mahar, who blogs at Health Beat, by invoking her name, derisively calling Gawande “the very Messiah of future healthcare delivery” to “people like” Mahar.
And so the rumble began, with Mahar writing a lengthy (and, god, do I mean “lengthy”) post defending Gawande’s message and unloading on Parks for criticizing it.
Buckeye, it seems, remains nostalgic for what he himself calls the “romanticized, individualized” model of the past — the doctor as Lone Ranger, a hero who takes full responsibility for his patients.
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Essentially, Mahar buys Gawande’s notion that medicine is no longer a matter of “individual heroism” and has instead — due to the sheer volume and complexity of medical information, which exceeds any one individual’s ability to grasp — become a “team sport.”
Parks then shot back at Mahar, saying that while he agrees with Gawande on some things and disagrees on others, that wasn’t the reasoning behind his original post. He simply thought Gawande gave a bad speech. “The point was to draw attention to the fact that the commencement address was lame and uninspiring, and completely inappropriate, given the context,” Parks wrote.
Mahar hasn’t issued a response, and the guess here is that she’ll let the issue die. So, before yet another example of blogger-on-blogger crime fades slowly (or more likely in this case, quickly) into our memories, we can take a moment to reflect on the issues raised in the Parks-Mahar debate: To what extent will the nature of practicing medicine change as medical information and technology becomes more complex and plentiful, and, perhaps more importantly — judging from recent efforts by Gawande and David Brooks — what ever happened to the happy-talk, “the-world-is-your-oyster” graduation speech?
Photo from flickr user nilsrinaldi