social business

Having to stop by the post office this morning I had half an hour to kill before heading over to the hospital for my shift at the Emergency Department so I popped in to the bookstore for a wee browse. Normally I stand in front of the new publications stand and flick through whatever looks promising whilst breathing in as much Fresh Book as I can (mhmmm...). Today I picked up an incredible book (the title of which annoyingly escapes me right now!) that profiled "unsung heroes" around the world. One of whom was this Frenchman who worked in Cambodia to set up restaurants/businesses that gave street children vocational training and with that, an education and a chance at an independent life. What I found the most interesting reading this was how he used his experiences working for the marketing department of L'oreal and his education from the prestigious Institut d'Etudes Politiques de Paris to shape his approach in making a sustainable impact.

The term they used in the book was "social business." And it got me thinking. It got me thinking about how Health is (or should be?) a sort of "social business." Don't get me wrong, I'm not referring to universal vs the U.S. model of privatized healthcare -- different topic, different issues, another time, lol. I'm referring to public health systems where most/all is paid by the taxpayer, provided for by the government. Being in amongst the world of health provider, I can't help but see so much waste and inefficiency in our system and how, at the end of the day, that means our patients, our community, lose out. I say this not as a criticism of the extremely hard-working health professionals (myself included!) and I'm not whining or picking faults for picking faults sake. I bring this up because I've been wondering what I want to do, career-wise, and incubating the question I was recently asked, "What gets you out of bed in the morning."

The silver lining of my five-hour shift in the Emergency Department (ED) today was the time I got to spend with the three patients I saw: getting to know them, chatting with them, making them a cup of tea. But that was it. And only partly was it due to do with my issues with ED (walk through the doors, cue: heart sinking; all that uncertainty and potential for serious shit-hitting-the-fan). I know, it makes it sound like I should be a social worker rather than a doctor but were I a social worker I would get too too frustrated having such a limited role in the patient's care.


With every issue, every situation, there's the Immediate. Yet with that there is always The Bigger Picture also. And in my mind the two are inextricably linked. I've always know I was a Bigger Picture person: my fundamental curiosity isn't to do with disease or pathology or medicine, but the Bigger Picture -- how does it tie in with the Immediate? How can the Immediate be improved at a grand scale by tackling the Bigger Picture? And I'm beginning to realise that I really can't change who I am. I can't change what tickles my fancy, my very own brand of immutable curiosity.

What is so attractive to me about the business model is how, when profit is involved, the dictating issues are efficiency, cost-productivity, getting the most out of what you put in. Now, is it just me who sees so clearly how much could be improved in the health sector if this model was applied?! In that sense, I wholly believe that the health should be a social business of sorts as well as non-government/Not-for-profit organisations. What kinds of organisations need efficiency, cost-productivity, getting the most out of what you put in, if not those with limited resources and such a huge need! Health systems, NGOs, volunteer organisations! They are filled with passionate people keen to make a difference, yet struggle in so many ways. I gave up pursuing international law as a career because I got frustrated sitting around talking about The Bigger Picture whilst doing nothing for the Immediate. And yet, now that I've fully immersed myself in the Immediate, I can see so clearly how the Bigger Picture has a revolutionary potential. We are naiive to think that either in isolation is all that is required.

At the end of the day, if a system is improved so that 200 more hip replacements can be done at the same cost -- or, scrap that, even just one -- I see so vividly the transformation, the impact, that it would have on the life of that 70 year old patient with debilitating osteoarthritis I have met oh-so many times throughout my training.

Now that would get me out of bed in the morning.