As more attention is paid to the idea of collaborative care, it's a good time to ask a key question: Why do doctors have such a hard time working together?
Do you see that kid sitting by the fence alone in the playground during recess? She's thinking about being a doctor when she grows up. Of course, so are a lot of kids too who are joyfully playing kickball, but, a lot of doctors simply don't play nice with others. Consequently, collaborative care is hard, interdisciplinary collaboration impossible, and there is plenty of anger and resentment to go around.
Doctors have a hard time playing nice with others because:
1. The medical school application process benefits those who go it alone.
2. The culture of medicine, particularly in some specialties, showcases the Lone Ranger mentality and, through mentors, perpetuates the stereotype.
3. They are distrustful of the motives of those not in the club.
4. They are know-it-alls who don't think they need help to do their jobs.
5. They are resentful about those trying to intrude on their turf.
6. They don't like what they are seeing happen to their profession.
7. They feel medicine is a zero-sum game and their piece of the pie is shrinking.
8. They object to the profit motive pre-empting patient care interests.
9. They are overwhelmed with the pace of change and suffering burnout and change fatigue.
10. They think and feel that the costs of playing nice with others is larger than the benefits both to themselves and their patients.
The single biggest challenge to creating sick care value through innovation is navigating the last mile, ie, motivating patients and doctors to change their behavior. Money won't do it. Technology won't do it. Twisting their arms won't do it. Threatening them won't do it. Nudging them and creating triggers, rewarding new habits and giving them incentives to sustain it just might. Give it a try and see what happens. You might even be chosen to be on the kickball team.