Thursday, January 12, 2012
Wisdom Deficit
We are confronted almost continually by the word "deficit". It has seemingly become part of our everday lexicon. Most often it is used in conjunction with a lack of a balanced Federal budget, but there are other more fundamental deficits that contribute to our budget woes. The main one, to my way of seeing the world, is that we individually and communally lack wisdom. In an age where answers to questions come at 4G speeds, information is accessible to almost everyone (at least in the developed world). Never has there been so much access to information - information that is often of questionable veracity. Yet, once an answer is found (the first answer found always wins) it is rarely debated on merit and the discussion moves on to the next "unknown". In any cases (in my experience) these factoids are quickly forgotten and there is no learning nor knowledge integration.
So, though we have answers to questions, there doesn't seem to be any increased knowledge nor facilitated journey towards wisdom. The average person can learn about anything on line these days. I can quite rapidly access quite detailed information on new pharmaceutical compounds that are manufactured using elegant biopharmaceutical techniques that act on ever more specific receptor sites on cells. My more than 25 year old biology and chemistry knowledge has been supplanted and I find myself exploring new vistas of cellular communication and replication that I never knew existed. Truly remarkable and wonderful! Yet, as I watch the development of these new compounds - which come into clinical trials at a dizzying rate nowadays - and see the tremendous price tags ($10,000/month in some cases)I'm at a loss to see how they will be wisely employed. The lack of ability to wisely employ these new and expensive compounds comes from a lack of a wise healthcare system which can adequately hold the tension of the new versus the proven.
Most of my professional career I've been tasked with evaluating new drugs for use within hospitals. It was my job to review these new products and to render a professional opinion on whether to allow these compounds to be used within a given organization. You might guess that at times I was very unpopular with both physicians and pharmaceutical company representatives. Yet my job was to evaluate the wisdom of adding a compound to that which was already available. What were the direct and indirect costs associated with the addition, what was the risk to the patients during the "learning curve" of the prescribers, what was the perceived legal and P.R. exposure for not having said compound available? The wisdom that I gained through this process is that there are very few innovative products developed - most are tag-a-longs to things we already have available. I also became wise in evaluating my bosses and whether or not they would support a certain recommendation. Wisdom, at least in my life, has often come at a fairly large price. Maybe that's why we have such a wisdom deficit - we don't seem to want to live with the suffering that accompanies it. Something to consider as we enter a time for choosing a new President and new legislators.
Peace for the journey,
Dan
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