It’s like Uber for Healthcare

Day 89: Wednesday

Morning, Tim!

Though not feeling poetic today, I love when I have enough energy and mental capacity to thoroughly enjoy my work.

I’ve been working on Non-Emergency Medical Transportation (NEMT) solutions recently.

A bit of background, followed by why I’m interested:

NEMT has traditionally been provided by an array of parties — ranging from taxis to shuttle buses, volunteers to high-priced ambulances. These services are needed not only for patients but for health systems, insurers, and tax-payers. Because transportation to and from an appointment can be a binary limiter on whether someone is able to receive care, the patient certainly has a stake. Importantly, though, because the patient’s health might otherwise deteriorate, health systems and insurers should also care, as handling sickness before it worsens is in almost every case less costly — even if it means multiple visits. Surgeries, scans, lab tests — they are all more expensive than a simple office visit to ensure someone maintains health. Tax-payers in turn should care, as their dollars are going to providing services and care for substantive portions of the population, both young and old.

The challenge of providing transportation fascinates me. Not only because I can throw out tons of transportation puns, getting on a good roll before someone tells me to put on the brakes because they can’t handle it and I have to stop (That derailed quickly). And not just because everyone in my line of work is talking about ‘the next Uber for healthcare’ when in fact, Uber could be the next Uber for healthcare. No, it’s in part because there are substantive operational considerations (i.e. if a patient is late to an appointment and backs up everyone else; if a patient is sitting in a bed waiting to be discharged but doesn’t yet have a ride, and so the hospital cannot use that bed; etc.). Yet the above stakeholders could also be interested for numerous other reasons — perhaps brand (look at how convenient we are!), patient experience (no one likes to wait around), or to better keep a broad population healthy and happy (taking patients to the pharmacy, community center, or beauty salon). It can be not only an issue of ‘sexy’, new solutions like Uber to make headlines to further a health system’s reputation, but also applying that same technology to address the social issues arising as barriers for those who often need care the most.

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There are tons of companies flooding the space, and it’s an exciting time to be looking at this work. I think it’s most exciting because of it is so broadly applicable, with the ability to interest so many.

Until tomorrow,
Zak

Socrates was Smart

Day 55: Friday

Good morning Zak,

Under the present circumstances I am reminded of something the wise old Socrates once said: “there is nothing more annoying than someone who quotes the wisdom of Socrates on almost every occasion.”

Maybe you don’t remember that one.  There’s a long tradition of falsely attributing things to Socrates, so it’s hard to know what the dude actually said.  For all we know he might have said that.  He might also have said, “come on guys, stop pretending to quote me all the time.”

Can you imagine being Socrates?  This is one of the things I spend a lot of time thinking about.  I mean, how frustrating would that be.  Like, one of my students represents me and my views however he wants in his books, and then those books get read for millennia after my death.  And I’m just supposed to be cool with that?

Zak, you raise a serious moral question. 

“Thinking about healthcare as a business feels kind of grimy at times — you are making money off of those who desperately need help, many times in order to live.”

This is the sort of thing that could keep a person in your shoes up at night.  But to me, it’s just a mildly entertaining intellectual exercise.  I’m not in your shoes.  Your shoes are like, ten sizes too big for me.  But in the face of an issue like this it would be nice to have access to some real wisdom…

The other day I walked past a mom with two boys practicing their multiplication facts:

“Tre per quattro.”

One of the boys was literally jumping up and down with energy, anxious to beat the other to the answer.

“Quindici!” “Dodici!”

We train little people to be very fast at these kinds of things.  I remember those days of training myself.  They might as well have thrown us circus peanuts when we got the answers right.

Some people know other things in the same kind of way.  Things besides math facts.  Many of us haven’t outgrown the habit.  For grownups in higher education, the fastest and loudest person… to identify the source of a Shakespeare quotation… wins the smartness contest.  That’s why we have standardized testing.

But, Zak, something’s just occurred to me: when thinking about a moral issue like healthcare monetization, the ability to quickly recall a large number of Shakespeare quotations is actually not that helpful.  I mean, I’m trying to remember… did Othello ever say anything smart about medicine?  Maybe if we recite the lines loudly enough the answer will come… “O THAT THIS TOO TOO SULLIED FLESH WOULD MELT!”

“The sages there were marked with dignity
And grave authority their faces showed.
They spoke infrequently with gentle voices.”

-IV.112-4, Inferno

One day, Zak, we’re going to make ourselves a nice little locus amoenus, a “pleasant place.”  You’re going to build us a library like you always say, and we’ll find one or two friends who will sit, read, and think… especially think.  That’s really all one could ever ask for.  Nothing beats rich conversation (well, nothing except for the fast, loud person who beats it).  For as Socrates himself once said, “the answers to the modern public health crisis lie in proper legislation and systemic reform.”

Until tomorrow,

Tim

Cat puns; Reasoning in foreign languages

Day 18: Wednesday

Morning, Tim!

Thank you for acknowledging my curation of cats. To be honest, I didn’t realize I was playing into the rampant trope of cat photos on the internet at the time, and so it was your work that really provided the curation.

As luck would have it, I recently got in an email chain spouting off cat puns. I’ve tried to curate the best of these below:

  • The first pun lobbed being less than purrfect, with a response to stop kittening around
  • Gratitude for fur-ends that would engage in such nonsense, tailented and hissterical as they may be
  • An acknowledgement that most of the cat puns weren’t very Clawver
  • And finally, from someone who had not been involved in the conversation, the suggestion that the laughter was going to cause them to “Puma pants — and that would be a catastrophe

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Tim you may have noticed in my last post my tendency to delve far too deeply into wordplay and puns. This is likely due to my fascination with language, albeit typically taking a different angle than your interest as a philologist. I recently came across some research suggesting that people make decisions differently when reasoning in a foreign language. Namely, when reasoning in a foreign language, people may be more willing to take on risk because they perceive risks to be lower. Additionally, when making moral decisions, reasoning in a foreign language also makes people more likely to espouse a utilitarian perspective (i.e., sacrifice one life to save five) than they otherwise would.

As you know, Tim, I work in the healthcare space. While I had been made aware of the risk-taking bias when reasoning in a foreign language, I had not made the connection to utilitarian action or to the suggestion outlined in the linked research above around the impact this may have on physicians reasoning in another language. Not having any conclusion yet, having just come across the research yesterday, I simply wanted to pass on the information to you, knowing it may be interesting from a philosophical perspective ala normative morality over utilitarian ethics as well as ongoing interest in impact on how languages impact thinking generally and what that may look like when extrapolating to a second language rather than an original, primary one.

Until tomorrow,

Zak