If The Conversation People Think Is Coming

Making Systems Work Is The Great Task Of My Generation Of Physicians And Scientists. But I Would Go Further And Say That Making Systems Work - Whether In Healthcare, Education, Climate Change, Making A Pathway Out Of Poverty - Is The Great Task Of Our Generation As A Whole.

Outsiders Tend To Be The First To Recognize The Inadequacies Of Our Social Institutions. But, Precisely Because They Are Outsiders, They Are Usually In A Poor Position To Fix Them.

Go Back To The '30s, '40s, '50s, And It Was The Discovery Of Heroic Interventions, The Ability To Cure People With Penicillin Or Do An Operation To Stop Disease That Was What Saved The Day. Primary Care Physicians Couldn't Do All That Much That Really Demonstrated A Difference. The People Who Control And Work With You To Control Your Blood Pressure, They're Not Rewarded For Doing That Or To Be Innovative About Doing That. So, The Result Is Half Of Americans Have Uncontrolled High Blood Pressure, Despite Seeing Clinicians.

We Now Have 30 Percent, For Example, Of Medicare Patients Who Are Seeing Doctors Who Are Rewarded For Doing This Kind Of Work, Like High Blood Pressure Control. So, The Affordable Care Act Has Pushed This Direction Down The Road.

In Many Ways, The Effort To Study Philosophy Was My Rebellion Away From Medicine. I'm The Son Of Two Indian Immigrant Physicians, So The Natural Path For Me Would Have Been To Become A Doctor. I Ended Up Doing The Master's Degree At Oxford In Politics, Philosophy, And Economics While Already Having A Seat In Medical School. I Was Keeping That As My Escape Hatch. But My Hope Was That I Might Become A Philosopher Or Something Else Entirely.