Perfect Prediction, Every Time

So it turns out being predictable may be boring but it pays the bills if you’re a meteorologist in New England, and increasingly if you work in healthcare. I mean in movies we say we like the unpredictable but to be honest we watch Apollo 13 over and over like 50 times not because Tom Hanks is a convincing astronaut but because we know the ending before it starts, and we love it. We sing with Icelandic Eurovision duo Will Ferrell and Rachel McAdams every morning before school this week because the music lifts us up and makes us laugh before the day starts. If it’s 720am, it’s time to play their SongaLong. It becomes our behavior. In healthcare we wish we could predict every outcome, but we can’t. We want to know that the surgery will take 3 hours, require 1 night in the hospital, no complications, 3 weeks of rehab and have Sally running pain free again by the time the Boston Marathon takes off from Hopkinton. We want to know that 20 visits with the behavioral therapist will cost the same each time, that the therapist will have Sally talking freely and confidently by the time she hangs her raincoat in that nursery school cubby in September. We want a good outcome but are sometimes afraid to pay for it. We are stuck often times in paying for each service and don’t have the systems to pay for a good result. We are afraid to change because it’s unpredictable. We ask our doctors to diagnose our pain, treat it and tell us that it will all be fine, but sometimes we forget this is life – and those tumors are unpredictable and might need more than a miracle drug.  I predict that by 2030 there will no longer be a fee for service, not without a guarantee that what you’re buying – a drug, a new knee, a better behavior, a pain free shoulder, a working heart, a clearer eye, a cure and a second chance – will be predictable. I’m as certain as I am that tomorrow’s weather will be mostly sunny, but here’s hoping….