Wednesday, September 3, 2014

Old Doctors in a New a Health Care World

My friend and colleague, Dr Jeff Rubin, will be speaking at the Stanford Medicine X conference on September 7th. Jeff and I are both in our early 60s, which does look younger and younger to me every day. However, we have both been in health care for well over thirty-five years and during those thirty-five years have been in clinical practice and in the world of care management and building health care systems. So when Jeff takes the podium on September 7th in Palo Alto, he will be old among the medicine Gen Xers.  In many ways, his message will help remind people that no matter how technology driven medicine is becoming, certain tenets of care must always hold true.

Jeff is a Clinical Psychologist, who in addition to being part of leadership at Accolade, still sees patients one day a week.  He and I and others helped found Accolade in order to use technology to foster relationships rather than to replace relationships. He is appearing before these medical entrepreneurs, many of whom believe that the future of medicine is a future of apps, self service medical protocols, and sophisticated data mining to give a message that says “yes” to those cutting edge tools but only when they are used in the context of a trusting, healing relationship between a health professional and a person in need. He will speak of the danger of believing so much in the tools, that issues of fear, sadness, and social isolation are not given the attention they deserve.

I have been to many such conferences over the past few years and I am always struck by the earnestness and energy of these young people who believe in their solutions’ abilities to solve the ills of our health care system. Many of their creative solutions will contribute a great deal to our health care needs and one can't help but share their enthusiasm when at these meetings. At the same time, people like me and Jeff know that all of these solutions must always be tested against the standard of how they impact the care of an individual in need. They must always be evaluated by how much they help the entire person and the entire family unit. They must understand that while physiology and pathology are the same across people, their experience of illness is dramatically different based on their culture, their family concerns, their finances, their emotional state, and their competing life priorities.

At Accolade, we have developed the new profession of Health Assistant and have used technology to give that patient and their Health Assistant access to the tools needed for them, as a social unit, to make the best decisions in health care. The decisions always rest with the patient and their family based on their values and their beliefs, informed by the best information and supported by the coordination, and the caring of their personal Health Assistant. It works and results in higher satisfaction in health care decisions, better quality of decision making, and lower costs. The technology is important but not as important as the patient-Health Assistant relationship.


I know that the message Jeff gives will be the most important message at the meeting. It will be to use technology as a tool but never to forget the need for a true human to human connection. Patients are people, and they are complex, interesting and different and deserve to be helped in ways that respect the unique aspects of each and every one of them. It takes more than apps, data and protocols to do that well.  It takes caring humanity.