Understanding the Healthcare / Medical System Crisis

An important driving force for healthcare problems is the mismatch of large but simple financial flows and complex treatments of individual patients by individual doctors. The problem of allocating resources leads to poor quality of care and high medical error rates. The solution to this problem requires two parallel but linked systems: (a) a high efficiency system that performs diagnostic screening tests inoculations and generic healthcare, and (b) a high complexity system that treats medical problems of individual patients. An understanding of complex systems, and particularly the dynamics of turbulence, provides direct insight into concerns about healthcare quality and medical errors. The existing system can be represented by a diagram representing the flow of information and treatments between patients and doctors, and the flow of money, largely from employers to healthcare insurers and thence to healthcare provider systems and individual physicians (see Figures 1). As in turbulent flow of a fluid, the process of breakup of a large scale flow into many fine scale flows naturally involves flows (eddies or whirls) on all intermediate scales. In fluid turbulence, the dissipation of large scale flows into microscopic thermal motion is ultimately responsible for turbulence. In the healthcare system, the process of allocation of financial flows to individual doctors treating individual patients for individual problems is responsible for rapid changes in management practices resulting in the current turmoil/turbulence.