Complexity and Simplification

Biology, as it unravels itself, demonstrates complexity of apparently infinite dimension. This is far beyond the understanding of the individual human and perhaps beyond the collective understanding of humankind.

When biology is compounded with the abnormalities of biology, as in medicine, the challenge is, for all practical purposes, insurmountable. Combined with this is the complicating phenomenon of “distribution curves” where the biological bulk must be distinguished from the “outliers”.

Therefore, in teaching medicine it is necessary to no longer isolated facts, but to teach the concept of infinite “complexity”. This is the challenge that faces the medical academic in the present century. It is no longer sufficient to attempt to install a plethora of “facts”. Indeed the teaching needs be directed away from the concept of satisfied with unitary “facts” as being sufficient.

The great danger of allowing contentment with “facts” is that medical management can easily become a “tick box” or “cookbook” realm, lacking in the perspectives of the full dimensions of the challenge.

But another, perhaps greater, problem lies with those who do not have a medical training. That is the public perception of healthcare by the layman. There is the (natural) tendency for the lay to reduce the complexities of healthcare to the binary and ultra-simplistic. The self confidence and self-assurance of the public has increased (via multiple modalities). Likewise the power, leverage and “muscle” of the lay public have increased so much as to superimpose itself upon the complexities of healthcare.

Individuals have now reached a position where they often believe that they “know best”. Of course, the healthcare professionals themselves have limitations, and there are times when they fall short of full understanding or composite knowledge. The limitations and errors of healthcare professionals are often inappropriately extracted from context, and then disproportionately amplified in the press, or in the law courts. But that does not mean that medical professional training is invalid – far from it – it remains the best available.

The popular opinion can be so powerful that it impose and distorts the practice of medicine and, frequently, usurps sound medical advice and valid modes of management.

One appellate court judge told me that she did not need to need any special expertise in making a judgement of healthcare matters, because she could “read all she needed to know in the newspapers”.

Another example of destructiveness has been the lay perception of the role of medications, including antibiotics. The latter have been widely seen as “necessary” in a “knee-jerk” reaction to almost all forms of illness. The biological result of this abuse and these misconceptions about antibiotic usefulness has caused many such medications to become uselessly impotent and ineffectual.

Another realm which has been questioned is the costs of healthcare. Whilst one does not contestant that all human activities can be abused in competitive extraction, nonetheless, the technology and research advances in medicine become progressively more expensive, and need to be factored into the economics of health care. Where technical advances continue and investment and maintained, the cost of healthcare must increase beyond inflationary devaluation of capital. And yet this does not seem to be generally recognised, however obvious it might be to the healthcare worker.

A further perversion is the provision of “national healthcare” whereby the greater population believes that it is “due” healthcare and demands attention and a determined extraction from the healthcare budget without regard for or understanding that most illness, for most people, self cure by one of the most wondrous of biological capacities.

It can be predicted that healthcare, as it is currently practised and made available, will shortly become self immolating.

Humans therefore need forceful instruction as to how they should behave in relation to the science of healthcare and to protect its availability.

Emphasis must be given to the pernicious dangers of the politicisation of healthcare, solely for the benefit of political ascendancy.