Will Rogers said once that “Even if you’re on the right track, you’ll get run over if you just sit there.” With recent events in the transplant world, his message seems eerily prescient. We recently saw the first successful xenotransplant in the US, and with it a myriad of publications subtly (and not so subtly) touting it as the “future of transplant.”
It’s not that surprising the hype cycle has ramped up so quickly around this event. Xenotransplants have all the key ingredients you’d need to get peoples’ attention – a lifesaving act, cutting edge gene editing, merging of humans and animals in a single body. Even the name xenotransplant sounds mysterious and futuristic (in fairness, any name that starts with X somehow seems cooler).
However, this single successful procedure has sparked widespread debate, dividing experts and the public into two distinct camps: those who hail Xenotransplants as the definitive solution to our chronic transplant issues, and those who warn they might be Pandora's Box, with a bevy of unforeseen problems that have yet to emerge.
Regardless of which camp people join, they are collectively adding to the one of the major unseen issues in healthcare – our “shiny objects” obsession.
For years I’ve watched the healthcare world witness a new advancement or technology enter their market and become enamored with proselytizing all the future effects (good or bad) that it may bring. Our fixation with these shiny objects is rarely short lived, with the hype around these phenomena often going on for years until they fade away and/or are replaced by a newer, better version. It’s like the saying goes – History doesn’t repeat itself, but it often rhymes.
Healthcare professionals in 2024: AI is going to use advanced computer processing power to help us improve diagnoses and treatments in healthcare.
Healthcare professionals in 2004: IBM Watson is going to use its advanced computer processing power to help us improve diagnoses and treatments in healthcare.
Healthcare professionals in 2024: Ozempic is a revolutionary weight loss pill that is going to help millions of Americans lose the weight they need so they can finally start getting healthy.
Healthcare professionals in 1994: Fen-phen is a revolutionary weight loss pill that is going to help millions of Americans lose the weight they need so they can finally start getting healthy.
I’m not implying that AI or Ozempic will have the same problems as their predecessors. Instead, I’m pointing out that we’ve spent decades with these once shiny objects firmly embedded in our consciousness, and yet the underlying problems for which they were developed remain largely unsolved. Xenotransplants are just the latest evolution of the human genome mapping project that was completed in 2003 and was supposed to create massive change in the world of healthcare “within a decade.” (Good thing time is a relative construct, right?)
Interestingly, time is a key part of our problem – we invest so much of it in preparation for a future built around these shiny objects, that we have almost nothing left to give to making things better today.
Unfortunately, the math makes sense in our minds – it feels better to spend time thinking about how Xenotransplant can create thousands of new transplants in the future, than it does to find ways to marginally improve the perpetually disjointed transplant waitlist system we use today. Thinking about it this way allows us to play a cognitive game of “kick the can”, where we avoid the ugly reality that we collectively don’t have the time or resources necessary to take on all the things in transplant (or the rest of healthcare) that have a life-or-death effect on peoples’ lives.
To be clear, no one in healthcare should be directly blamed for the shiny object obsession. Maybe more than any other industry, our healthcare system is besieged with ingrained and intractable problems. And those working in healthcare have been given the unenviable task of navigating around those systemic problems as they struggle to not to lose more ground (and lives) to the broken system. And when you spend each day desperately battling unbeatable problems, you become a lot more inclined to look for shiny, silver bullets to save the day.
Our real challenge is not to avoid shiny objects, but to be cognizant of our obsession and to try to not let it distract us from doing the hard work required to make small improvements. Yes, the healthcare system is broken. Yes, the constant pressure and stress are driving people away. Yes, we cannot fix everything and save everyone.
But we should still try.
We should try because today there are 550,000+ people on the transplant waitlist who will, in all reality, never get a chance to get a xenotransplant, but may have a chance to get an old fashion human organ if, for example, we can make the active/inactive listing process (which can generously be described as a “dumpster fire”) a little better. Will that fix be hard? Yes, it will be. Will it be worth all the effort? I guess that depends on the value you place on human life, but I’d like to think so.
Also, if we are willing to be vigilant about our obsession, there is a role shiny objects can play in making healthcare better. That’s because hope is at the heart of our fixation. We hope shiny objects can solve the problem, we hope they save lives, we hope they can change the world. That hope, properly channeled, can drive progress in healthcare, and we’ll gladly take anything that helps with that.
We can tighten processes, advocate for money allocation toward less valued specialties, encourage interdisciplinary collaboration… advancing cutting-edge care shouldn’t result in abandoning incremental changes – those are equally as vital. In the end, Will Rogers advice hits home. Healthcare will always be tempted to stop and stare at the newest shiny object, but we’ll also have to keep pushing forward with making things better today.
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