Can You Tackle Complex Problems with Simple Solutions?
“Doc — I just want a simple solution to my problem — just, fix it!”
Our patients present with a variety of problems.
In the spine world — the actual source of pain can often be difficult to ascertain.
We quickly realize that very few of our “real life” patients act like the “textbook” patients that we train on.And soon enough, what we thought were simple categorical problems — become a bit more complex.
Even presenting the risks of surgery — we quickly realize the complexity of the situation. Patients just want to get better, to not have pain, to be able to travel, to engage in exercise, etc... But, they have a complex framework through which they make decisions involving risk that goes far beyond the simple percentage chance of a complication or improvement.
Patients often compare themselves to a broken down car that just needs a mechanic to fix their parts. As a surgeon, sometimes we want to think that way too —- and appreciate the hopeful instant gratification of our teamwork. But, we know all too well — this is often not the case. The human element alone adds a level of complexity and variability.
*Ultimately, I just feel that complex solutions are usually difficult to understand and difficult to implement. The beauty of simplicity is everyone can understand the solution, execute the plan, and with that understanding comes a higher probability of success and better outcomes.*
So, how can we break down these (spine) complexities?
- Don’t start planning your solutions with the level of invasiveness of the procedure, but rather the effectiveness of your techniques and approach
- Learn from others' experiences. You’ll often find that 1+1=3, as multiple perspectives can simplify your approach (double-edged sward — “too many cooks in the kitchen”). Encourage a “group recommendation” based on diverse inputs.
- Be transparent with your thought process and allow your patient access to the complexity you face. From there, you can slowly break the approach down into several more simple complementary tasks and goals — you’ll have to do that anyways in order to help them understand the issue at hand.
- Understand that Rome wasn’t built in a day (or a week, or a month…), and it may take time and several drawn out “simple” steps along the way (pre-op optimization, pain mgmt, support system, etc..) to reduce the complexity of the treatment/solution as a whole.
Yes — much of my question can be poked and prodded on the basis of “semantics.” And I know you cannot “fix” a spinal deformity with an epidural steroid injection or an MIS TLIF!
But if you can solve some of the problem with several safe small steps, rather than a risky HOME RUN — is that wrong?
So yes, “simple” problems can certainly be solved by “simple” solutions…
But, are there any such things as “simple” problems in healthcare anymore?
And are we becoming “human mechanics” if we start seeing problems as “simple”?