Commentary

What Drives Change in Medicine?


 

During the last presentation on the last day of the SDEF Summit in Aesthetic Medicine, Dr. R. Rox Anderson shared his observations on creating change in the world of medicine. As the person who conceived or helped develop many of the non-invasive treatments widely used to remove birthmarks, microvascular and pigmented lesions, tattoos and hair, he should know a thing or two about the topic.

"It takes people with passion," Dr. Anderson, professor of dermatology at Harvard Medical School, Boston, said of change-leaders. "We're driven to help other people. That is my primary passion. I go to work every-day thinking, 'Science for the people.' It's also important to get very specific about the problem. I've noticed that the ability to really define the problem and own it is often where some of the passion comes from. Working on something that someone else told you about often does not sustain the process that you have to go through to make substantial change."

Dr. Rox Anderson

Dr. R. Rox Anderson

Change-leaders exhibit unbridled curiosity mixed with healthy skepticism. "It's interesting how change can happen if you mix people who are very problem-oriented with people who are very technology-oriented," said Dr. Anderson, who also directs the Wellman Center for Photomedicine. "I kind of walk around with two bags: One of them you might label 'Problems I care about but don’t know how to solve'; the other one 'Stuff I know about technology-wise.' The challenge is to connect the two. I don't know how that happens, but when it happens right, you get change."

Change leaders tend to be resilient, he said, explaining that real change is usually either threatening or surprising. "There's a phrase, 'You can tell the pioneers by the arrows in their backs.' People are very uncomfortable with change. You will find that if you’re trying to put something new out there, you may threaten someone's paradigm."

In the business of medicine, he continued, "the bottom line is helping others. In medicine, if the problem isn't about helping people, it's going to fail. If you're not curious and skeptical about something important, you'll be off on some tangent that won't ultimately make a tangible change."

Strong commitment to the problem you're trying to solve is essential, he said. He likened the level of commitment to a marriage in which you "Write a grant and start making phone calls to your colleagues, get a collaborative group together and say, 'We're going to attack this problem.' Then you and the problem have 'children' – three or four ideas [of how to] solve the problem. Some of them work, some of them don't. It's the ones that don’t work that teach you things. My definition for bad research is that you can predict the outcome."

— Doug Brunk

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