There is another element of American military culture that is very different from medical culture and that is the emphasis on teams. When my son applied to West Point, being a captain on a team was very helpful to your prospects for admission. Some evidence of being able to work with others others in a coordinated way is key. That is because teamwork is essential to successful military operations. Here is a quote from the current US Army manual on teamwork: “Building cohesive teams through mutual trust is a principle of mission command and an essential skill for Army leaders.” That is the level of emphasis and it is even more important in special operations. These teams engage in complicated high-risk operations that require extensive planning. Every team member has a carefully defined role in each unique mission and they “must understand and be able to actively contribute to the planning process to assure success.”
The difference between the military officer and medical provider begins in the selection process. Acceptance into medical school is totally dependent on what you have accomplished as an individual. Sure, you should have some extracurricular activities that show you are well-rounded but that is still about YOU! There is nothing about being able to function on a team. It is all about grades and standardized test scores. In a special operations team, there are officers, non-comissioned officers, and enlisted men, but everyone “must understand and be able to actively contribute to the planning process to assure success.”
This difference is a huge barrier to better health at lower cost. Chronic diseases generate most premature death, disability, and medical costs. In Medicare, patients with cardiovascular and related conditions may lead to sixty percent of all spending. Treating these diseases is a team sport. Providing optimal medical therapy for cardiovascular disease requires just as much team preparation as a military special operations mission. Every member of the team “must understand and be able to actively contribute to the planning process to assure success.” When your chronic disease teams function like that, every member will contribute to the maximum degree allowed by their license.
Medicine is still a top down profession. Doctors are running the show and telling those who support them what to do. They are not using protocols and systems and they are treating patients based on what they remember from medical school and continuing education. High functioning teams focused on chronic disease are unusual. That approach is outdated. It doesn’t work very well. High blood pressure is the most common cause of an internal medicine office visit. Only 44% of Americans with hypertension have their blood pressure controlled to less than 140/90. A medical special operations team focused on hypertension control achieves a hypertension control rate of 90%. Every team member understands the mission and contributes to achieving the best possible control of blood pressure. A similar team focused on optimal medical therapy for cardiometabolic disease can care for patients with high blood pressure and achieve the same level of blood pressure control. It can provide an equal level of excellence for high cholesterol, diabetes, chronic kidney disease, heart failure, heart attack, stroke and atherosclerosis. It can lead to much better clinical and financial outcomes.
Our core business is helping you develop and support teams like this to consistently produce optimal medical therapy. Contact me at whbester@gmail.com.
Love the team emphasis. On the other hand, I know the value of individual work - like these Substacks. The program I've just created. My doctoral work. And so much more. I didn't, and with the Substack posts, don't want to be doing them as part of a team. I have also seen teams crippling participants. All the same, I very much value being in a team. I've been part of very effective teams.