Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

We need a radical change in the way health care is delivered

Gary Oftedahl, MD
Policy
July 9, 2011
32 Shares
Share
Tweet
Share

Many of you are familiar with the famous “invisible gorilla” experiment, wherein an audience, being instructed to watch closely for the number of passes made with a basketball, fails to  see a rather large and deliberate gorilla march slowly across the screen, stop in mid  picture and thump its chest.

In fact over 1/2 of those tested failed to notice this obvious action.  The predominant response is one of suspicion and denial—”you showed a different video.”  It is all part of an eloquent piece of work that raises several issues regarding “illusions” predominant in human behavior.

In a remarkable and somewhat disturbing book, The Invisible Gorilla, Christopher Charbis and his co-authors address the six illusions of human intuition, which should cause us to reflect and consider the confidence and commitment we have in regard to our senses.  It’s an entertaining sojourn providing multiple enlightening and often frightening examples of how these six illusions have unintended consequences.  As in many of my other posts, this understanding of the foibles of human behavior creates many concerns about the assumptions we’ve made in the past.   In fact, I hope I’m never in a position where an eyewitness account of my behavior is taken as “gospel truth” in a serious situation.

That being said, I was pondering if any of these six illusions (as opposed to the seven deadly sins) might raise additional concern regarding the evolving work in health care reform, specifically surrounding the high level of energy around the patient-centered medical home/health care home which is spreading  across the country.

Now I’m not a naysayer, and in fact am firmly in the camp of those feeling we need a radical change in the way our  health care system is structured and health care delivered.  I’m just struck after reading this book that there are perhaps examples of the issues raised by the authors in some of the thinking and planning presently underway.

First, the six illusions–attention, knowledge, confidence, cause, memory, and potential.  The book spends a great deal of time, and quite convincingly, making the case that our  “intuition” about our behaviors in all of these areas is not consistent with our true capabilities and leads us into some dangerous and dark corners.  Shackled with the challenge of being a human and the associated behaviors of our species, we exhibit some or all of the illusions mentioned in our behaviors.

Hence the invisible gorilla identifies that our  “attention” is often focused, and limits our ability to see or sense the unexpected.  Multiple studies have demonstrated that we notice what we’re looking for or what we expect to see.   Our “attention” is actually limited and often misses issues which are obvious to others–but which we’re convinced we were considering.

Is it possible that while well motivated, we may be missing details regarding essential attributes of our work in medical home–that there may be an “invisible gorilla” which needs to be seen?  We’re attending to the details we think are important, and I’ve no doubt they are.  But what about the things we’re not attending to?  I’m not certain I can even list them well, because then they wouldn’t be “invisible.”

Are we fully using asynchronous technology—smart phones, iPads, social media—in creating our models?  Are we cognizant of the diverse cultural differences, both ethnic and generational, which need to be addressed?  As the population ages, do our “homes” come with assisted living where necessary? Have we begun to address the persistent duality of mental health/physical health which permeates our system, and perpetuates approaches which would preclude many from taking up “residence” in that proposed home?

It’s my nature to be reflective, and to rarely see things as black or white or absolute truths, but understanding the insidious and pervasive nature of this one illusion–attention–I often wonder what will surprise me soon as something which should have been considered but wasn’t.

And that’s only one illusion–consider the others.  The illusion of knowledge–thinking we know all we need to know–and that of confidence–we’ve got the answer–are often voiced by proponents.  They speak with some certainty about moving the medical home efforts forward.  From what I’ve read, it’s perhaps natural that I feel an urge at times to run the other way—my inherent fear of invisible gorillas I guess.

What’s frightening to me is that this is only touching a few of the illusions.  But even these should make us step back and take the time to consider if this exciting and potentially transformational approach is already inhabited by what might be a danger to it’s long-term success–that “invisible gorilla” which we all miss in one way or another.

For this reason, among many, the need to collaborate and engage others is paramount  Creating an environment where we can share ideas, challenge concepts and approaches, engage in spirited discussion that promotes disagreement is key.  Only then can we be better positioned to appreciate that big hairy animal standing amongst us that alone we’ll not notice.

Gary Oftedahl is Chief Knowledge Officer of the Institute for Clinical Systems Improvement.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

Should young athletes be screened for heart disease?

July 8, 2011 Kevin 15
…
Next

Medical marijuana in psychiatric illness

July 9, 2011 Kevin 10
…

Post navigation

< Previous Post
Should young athletes be screened for heart disease?
Next Post >
Medical marijuana in psychiatric illness

More by Gary Oftedahl, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Embrace the explosion of the new technologies

    Gary Oftedahl, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Physicians lack harmony in this age of health reform

    Gary Oftedahl, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Is health care ready for the iPad and other new technology?

    Gary Oftedahl, MD

More in Policy

  • Pediatricians grapple with guns in America, from Band-Aids to bullets

    Tasia Isbell, MD, MPH
  • Health care wins, losses, and lessons

    Robert Pearl, MD
  • Maximizing care amidst provider shortages: the power of measurement-based care

    Tom Zaubler, MD
  • Unveiling excessive medical billing and greed

    Amol Saxena, DPM, MPH
  • Chronic health issues and homelessness

    Michele Luckenbaugh
  • The impact of certificate of need laws on rural health care

    Jaimie Cavanaugh, JD and Daryl James
  • Most Popular

  • Past Week

    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • I’m tired of being a distracted doctor

      Shiv Rao, MD | Tech
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Debating the role of psychiatric assessments in medical decisions

      Christian Youssef & Francisco M. Torres, MD | Conditions
    • Balancing motherhood and medicine [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Misunderstandings about opioid use disorder

      Amy Baxter, MD | Conditions
  • Recent Posts

    • Debating the role of psychiatric assessments in medical decisions

      Christian Youssef & Francisco M. Torres, MD | Conditions
    • Navigating adulthood in the digital age

      Eleanor Menzin, MD | Physician
    • 5 things to know about weight from a bariatric surgeon

      Maria Iliakova, MD | Conditions
    • Out-of-office infusions in oncology care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The power of business knowledge for medical professionals

      Curtis G. Graham, MD | Physician
    • Using the language of art to create work-life balance

      Sarah Samaan, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 6 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • New Schizophrenia Treatments Are Coming: Don't Panic
  • Heavy Drinking Not Tied to Lower Response to DAAs for Hepatitis C
  • Higher Suicide Risk in Nurses, Other Health Workers
  • COVID Drug and New Mutations; Costco Offers $29 Care; Trump Unmasked Over Bronzer
  • Long COVID Rare in U.S. Kids, Has Affected 7% of Adults

Meeting Coverage

  • New Schizophrenia Treatments Are Coming: Don't Panic
  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • AI Has an Image Problem in Healthcare, Expert Says
  • Want Better Health Outcomes? Check Out What Other Countries Do
  • Most Popular

  • Past Week

    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • I’m tired of being a distracted doctor

      Shiv Rao, MD | Tech
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Debating the role of psychiatric assessments in medical decisions

      Christian Youssef & Francisco M. Torres, MD | Conditions
    • Balancing motherhood and medicine [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Misunderstandings about opioid use disorder

      Amy Baxter, MD | Conditions
  • Recent Posts

    • Debating the role of psychiatric assessments in medical decisions

      Christian Youssef & Francisco M. Torres, MD | Conditions
    • Navigating adulthood in the digital age

      Eleanor Menzin, MD | Physician
    • 5 things to know about weight from a bariatric surgeon

      Maria Iliakova, MD | Conditions
    • Out-of-office infusions in oncology care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The power of business knowledge for medical professionals

      Curtis G. Graham, MD | Physician
    • Using the language of art to create work-life balance

      Sarah Samaan, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

We need a radical change in the way health care is delivered
6 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...