Are We Having Fun Yet?

I think I have realized what healthcare's big problem is, and it's not what you might think. 

It's not high prices, although they certainly are a big problem.  It's not the fee-for-service model, although it gives too many people perverse incentives.  It's not the lack of useful and understandable quality measures, although it is astonishing that we don't have them.  It's not even the byzantine and often stifling regulations that healthcare operates under, although too often they seem to do as much harm as good. 

No, the big problem with healthcare is that not enough people are having fun.

Wait, what?  How could this be "the" big problem with healthcare, which has so very many problems?  Healthcare is not supposed to be fun.  It's supposed to be serious, we're supposed to take our health and our healthcare seriously, and we expect the people working in healthcare to be serious professionals.

Yes, there is a lot that is, and needs to be, serious about health and healthcare, but here's where the fun comes in -- Steven Johnson's great quote:

You will find the future where people are having the most fun. 

If you haven't read it, Steven Johnson's Wonderland: How Play Made the Modern World makes the case that innovation, and changes in society, come from people "playing" -- having fun.  Mr. Johnson is someone who knows something about innovation, his previous books also include Where Good Ideas Come from: A Natural History of Innovation and How We Got to Now: Six Innovations That Made the Modern World. 

A longer quote from Wonderland helps further explain his thesis:

When human beings create and share experiences designed to delight or amaze, they often end up transforming society in more dramatic ways than people focused on more utilitarian concerns.

So who are the people in healthcare having fun?  Where are the people in healthcare creating experiences designed to delight and amaze?  There must be some, somewhere, but they're too few and far between, and neither "fun" nor "play" are attributes that people usually even associate with healthcare.

Doctors are stressed and, increasingly, reporting burnout.  They more often advise people not to enter the profession.  Patients are frustrated and, all too often, worried or even scared.  As has pointed out, the fact that "patient-centered" even has to be discussed illustrates how it isn't true.  No one seems to like our current healthcare system, or agree on how to make it better.  We're paying too much -- way too much -- for health results that are, frankly, mediocre at best.  This is all serious stuff.

When it comes to healthcare, taking time to play seems irresponsible.  Having fun is something people are supposed to do in the rest of their lives.  So we grumble about our weight, we promise to exercise more in the future, we sit in waiting rooms for far too long for our too-short visit with our clinicians, while those clinicians end up being expected to deliver assembly-line medicine and serve as, in the words of the AMA, the world's most expensive data entry clerks. 

Certainly, there must be people in healthcare having fun.  I mean, there are people in healthcare working on robots, 3D printing, virtual reality, implantable devices, and body hacking, to name a few.  Those have to be fun, right?  No wonder, because those kinds of things are going to be where the future of healthcare are going to be.

The people working on those, though, are probably being told to make their inventions more useful, sooner, not to make them more fun.  They award Nobel Prizes in Medicine for discoveries that deliver the "greatest benefit on mankind," and the judges probably don't take fun into account.  That's how innovation in healthcare often delivers change that is, essentially, more of the same.   

But where's the fun in helping people stay healthy?  Where's the fun in making the healthcare experience fun?  When are we delighted and amazed in healthcare? 

Eating healthy often seems less fun than eating junk food.   Exercising is usually not as fun as watching television.  Most people have more fun checking on their tablet or smartphone than getting extra sleep.  Getting a procedure is almost never fun, and taking prescriptions is a chore. 

We've allowed healthy to become the not-fun option. 

If I often write about seemingly unrelated things like TikTok, WeWork, Fortnite, or e-sports, it's because people seem to be having fun there.  They're telling us something about the future.  As I said in the Fortnite article,

The future of the healthcare system is going to be participatory, cooperative, interactive, iterative, online, rewarding, challenging but fun.

Mr. Johnson would understand. 

So, yes, let's do a better job with measuring and rewarding value in healthcare.  Let's do a better job of ensuring care is affordable.  Let's do a better job of keeping people independent.  Let's do a better job preventing conditions, and managing them once they've developed.  Let's make the patient experience less arduous.  But let's not forget the fun.

Let's encourage innovation in healthcare that people find fun, whether they are clinicians, patients, or people who aren't either.  Let's look for ways to make the healthy choice the fun option.  And let's not be satisfied until we have healthcare experiences that delight and amaze the people involved in them. 

Wouldn't that be fun?