TEXTO

Engaging Doctors in the Health Care Revolution

  Despite wondrous advances in medicine and technology, health care regularly fails at the fundamental job of any business: to reliably deliver what its customers need. In the face of ever-increasing complexity, the hard work and best intentions of individual physicians can no longer guarantee efficient, high-quality care. Fixing health care will require a radical transformation, moving from a system organized around individual physicians to a team-based approach focused on patients. Doctors, of course, must be central players in the transformation: Any ambitious strategy that they do not embrace is doomed.

  And yet, many physicians are deeply anxious about the changes under way and are mourning real or anticipated losses of autonomy, respect, and income. They are being told that they must accept new organizational structures, ways of working, payment models, and performance goals. They struggle to care for the endless stream of patients who want to be seen, but they constantly hear that much of what they do is waste. They’re moving at various rates through the stages of grief: A few are still in denial, but many are in the second stage—anger. Bursts of rage over relatively small issues are common.

  Given doctors’ angst, how can leaders best engage them in redesigning care? In our roles in senior management of two large U.S. health care systems, and as observers and partners of many others, we have seen firsthand that winning physicians’ support takes more than simple incentives. Leaders at all levels must draw on reserves of optimism, courage, and resilience. They must develop an understanding of behavioral economics and social capital and be ready to part company with clinicians who refuse to work with their colleagues to improve outcomes and efficiency.

  To help health care leaders engage physicians in the pursuit of their organizations’ greater goals, we suggest a framework based on the writings of the economist and sociologist Max Weber, who described four motivations that drive social action (that is, action in response to others’ behavior). Adapted for health care professionals, these are: shared purpose, self-interest, respect, and tradition. Leaders can use these levers to earn doctors’ buy-in and bring about the change the system so urgently needs.

(Adapted from www.hbr.org)

WHAT IS LIFE?

The magazine Philosophy Now asked two people, Tom Baranski and Courtney Walsh, to define what life is.

Tom Baranski from Somerset, New Jersey, believes that life is the aspect of existence that processes, acts,
reacts, evaluates and evolves through growth (reproduction and metabolism). The crucial difference
between life and non-life (or non-living things) is that life uses energy for physical and conscious
development. Life is anything that grows and eventually dies, ceases to proliferate and be cognizant. Can
[5] we say that viruses, for example, are cognizant? Yes, insofar as they react to stimuli; but they are alive
essentially because they reproduce and grow. Computers are non-living because even though they can
cognize, they do not develop biologically (grow) and cannot produce offspring. It is not cognition that
determines life: it is rather proliferation and maturation towards a state of death; and death occurs only to
living substances.

[10] Or is the question “What is the meaning (purpose) of life?” that is a real tough one? But Tom Baranski
thinks that the meaning of life is the ideals we impose upon it, what we demand of it. The meaning of life
is to: Do good, Be Good, but also to Receive Good. The foggy term in this advice, of course, is “good”; but
he leaves that to the intuitive powers that we all share.

There are, of course, many intuitively clear examples of Doing Good. Most of us would avoid murdering;
[15] and most of us would refrain from other acts we find intuitively wrong. So our natural intuitions determine
the meaning of life for us; and it seems for other species as well, for those intuitions resonate through
much of life and give it its purpose.

On the other hand, Courtney Walsh from Farnborough, Hampshire, defines life as the eternal and
unbroken flow of infinite rippling simultaneous events that by a fortuitous chain has led to this universe
[20] of elements we are all suspended in, that has somehow led to this present experience of sentient existence.
Animal life (excluding that of humans) shows that life is a simple matter of being, by means of a modest
routine of eating, sleeping and reproducing. Animals balance their days between these necessities, doing
only what their bodies ask of them. The life of vegetation is not far from that of animals. They eat and
sleep and reproduce in their own way, for the same result. So life is a beautiful and naturally harmonious
[25] borrowing of energy.

Yet we have taken it for granted. We have lost the power to simply be happy eating, sleeping, reproducing,
believing we need a reason to be alive, a purpose and a goal to reach, so that on our deathbeds (something
we have been made to fear) we can look back and tell ourselves we have done something with our lives.
Life has lost its purpose because we have tried to give it one. The truth is that we are no more significant
[30] than the sand by the sea or the clouds in the sky. No more significant. But as significant.

No matter what your race, religion or gender, when you first step outside your door in the morning and
feel the fresh air in your lungs and the morning sun on your face, you close your eyes and smile. In that
moment you are feeling life as it should be.

Adaptado de philosophynow.org.

UK scientific advisor says coronavirus unlikely to be eradicated

    The coronavirus will be around for “evermore” as it is unlikely it will be eradicated, a British scientist on the
government’s advisory committee for the pandemic said on Wednesday, although a vaccine would help
improve the situation.
    Britain, like other countries in Europe, is currently in the grip of a resurgence in COVID-19 infections, with
[5] much of the country under local restrictions and more than 21,000 daily cases reported on Tuesday.
    “We are going to have to live with this virus for evermore. There is very little chance that it’s going to
become eradicated,” John Edmunds, a member of Scientific Advisory Group for Emergencies (SAGE), told
lawmakers.
    Although the coronavirus will be around indefinitely, Edmunds said that the prospect of a vaccine towards
[10] the end of the winter should impact the government’s strategy now.
    “If vaccines are just around the corner then, in my view, we should try and keep the incidence as low as
we can now, because we will be able to use vaccines in the not too distant future,” he said.
    He said the UK had played a “clever game” in investing in different coronavirus vaccines. Britain has signed
supply deals for six different COVID-19 vaccines, with 340 million doses secured across different types of
[15] technologies.
    “I think we will be in a reasonable position in months,” he said. “I don’t think we’re going to be vaccinating
everybody, but to start, maybe the highest risk people, healthcare workers and so on."

(Adaptado de: SMOUT, Alistair. UK scientific advisor says coronavirus unlikely to be eradicated. In: Reuters. Data de publicação: 21 out. 2020. Disponível em: https://www.reuters.com/article/us-health-coronavirus-britain-sage/uk-scientific-advisor-says-coronavirus-unlikely-to-be-eradicatedidUSKBN276174. Acesso em: 21 out. 2020).