Section v: perceptive error in the medical industry
Richard dawkins has said that it is our lucky thing that human beings die in their own way. Most people cannot die because they were never born. Those who may be like me but never have the chance to see a ray of sunlight are more than the sand in the arab desert. Of these unborn spirits, there must be poets better than yeh tsai and more talented than newton. We know that because the mathematically possible gene mix is much larger than the number of human beings who actually live. From this amazing little chance that a common man like you and me can meet one another in this world。
We are still alive, as a result of every kind of luck and coincidence. The basis for survival is less error, with 23 million pairs of dna in humans and 3 billion pairs of alkalis, but only about 22,000 genes, and less than 10 per cent of all alkalis are valid codes. So what's the rest? Scientists speculated that it was a “correction” system。
The most important concern for the design or application of a bottom-up business model in the medical industry should be to avoid errors. This is another element of model thinking。
I. Learning bad is easy to learn: prisoners ' plight and window breaking response
The prisoners ' plight is a game model launched in 1950 by two researchers of the united states company rand. The story is that the police arrested two thieves, detained separately and interrogated separately. If both individuals are silent because of insufficient evidence, the sentence is one year each; if one denounces and the other is silent, the person who denounces can be released in court and the other is sentenced to 10 years in court; and if both exposes, the evidence is conclusive, the sentence is eight years each. Finally, the choice between the two was to expose each other。
This example reflects the best choice of the individual, not of the group. Or in a group, individuals make rational choices that often lead to collective irrationality. While the dilemma itself is of a model nature, similar situations can occur frequently in real-life price competition, environmental protection, etc. The main reason for this is the industry-wide abandonment of cooperation and trust, which, while it is against the best common interest to sell each other, may allow it to reap its best interests。
Price warfare in the medical industry is the most typical interpretation of prisoners' plight. Prices are not lowest, but lower. I've seen $9. 9 full-year hairless membership cards. Attempts to crush rivals with price battles are typical of a thousand enemies and 800 for their own gain. Because the dumping of medical services through the dumping of customized products, the application of price competition in agricultural markets, is a violation of basic rules and, ultimately, the loss of profits not only from their own institutions but also from the entire industry, there are few winners in the health-care price battle。
The competitive ranking that prevailed in 100-degree searches that year was also a multi-cycle game in the plight of prisoners. There will be no collaboration, cooperation or mutual trust among competitors when advertising at 100 degrees, because the platform is the designer of the game, and the competitive costs and costs of advertising are increasing for each player, but income has not increased accordingly and profitability is declining. The medical group tsuda had tried to join forces, but had failed because there was a competitive relationship between them and it could not really unite. Such resistance becomes meaningless whenever one of its members betrays or sells others。
As an emerging industry, it is not surprising to experience early brutal growth and disorderly competition, especially in the absence of rules, where people tend to learn bad. A family that uses two books to avoid taxes will follow suit; a family that uses counterfeit products will follow suit, another typical error - the “window breaker effect”。
A few broken windows in a building, and if those windows were not repaired, there might be more spoilers to destroy more windows. They not only break more glass, but even destroy the whole building。
This is the psychological “window-breaker effect”, the first conclusion of criminal psychology, that if left unattended in the environment, it could induce people to follow suit and even intensify. The “window breaker theory” came from the 19th-century french economist bassia and, in short, “harm is good” and was later introduced as a theory of criminal psychology by the american political scientist james wilson and the criminal scientist george karine。
When practitioners compete for practices that undermine public resources or the public interest, such as the use of counterfeit products, the infringement of intellectual property rights, etc., they inevitably lead to the failure of business models. The medical-american business model should not be explained by the tragedy of the common land, which, if applied, could not exist. The tragedy of the common land means that the beneficiaries seek to gain more from it from their own personal interests, at a cost to all. This name comes from a range of pastures in the heart of ancient english townships, where resources are exploited and used beyond limits and become depleted and fished. What are its public resources in the field of health care? For example, abuse of media platforms, encroachment on tax resources, etc。
A representative example still comes from hundreds of degrees. Google has a declaration of values called “no evil”, but it is not a dogma. Information searches have the attributes of public resources, especially when google is pushed out of the chinese market and the 100-degree family is unique, and should have given greater prominence to the nature of its search. However, the predatory development of the company itself with a large number of users has reduced the credibility of the search. Today, few health-care providers have also made 100-degree bids a major part of the marketing budget。
The window breaker effect reveals the strong intuitive and induced effect of the environment on the psychological formation and behaviour of people, which is closely related and mutually causal. The social environment is also likely to have a window-breaking effect, and when the overall economic situation is poor and institutions are poorly run, the prevailing negative sentiment affects everyone, rather than cherishing hard-won business opportunities, but displays a low level of work driven by the psychological drive to break cans。
The curse of avoiding the window effect requires industry-wide cooperation. In the past, the medical profession has also been involved in a number of professional integrity unions and swearing-in activities, but the results have not been significant。
Ii. Do not act with evil: a landslide effect response
The book " social animals " , co-authored by carol taveris and elliot allensen of the united states, says that there are many strange, irrational, anti-intuitive phenomena in life. The slope effect is one of them. It refers to the degree of immorality of an individual, with a tendency to increase over time, i. E. The repetitive and progressive nature of immoral behaviour. It is widespread at the individual level and in the process of interpersonal interaction, which can affect normal social interaction and even hinder the harmonious and healthy development of society. For example, it is easy to say a little lie, but it takes a lot of lies to go round, so the greater the lie。
It is easy for policymakers to detect immorality for large changes, while minor changes in behaviour are not easily detectable and are difficult to define as unconscionable. The slope effect seems to have slipped from a slope, and if it slips slowly, it may not feel too much, but it may slip faster, and eventually it will not hold. The effect of the landslides is like hot water boiling frogs, so we often say, "do not do it with evil。
There is a saying: when an avalanche, no snowflake is innocent. According to the source, no snowflake is immune. For example, false advertising and tax evasion are widespread and have led to deep-seated industry。
Avoiding landslides is particularly important for consumer medicine. Because medical compliance is a continuous process of “records of events” similar to procedural justice and “correct assessment”, like a long chain, where any link is flawed, the whole chain breaks. Thus, process management is the bottom logic of medicine and the key to the success of the consumer medical business model。
Iii. Path dependence — is this what medicine is born of
Path dependence stems from fear of risk, including psychological and model dependence. For example, the reliance of market-based beauty surgeons on the path of public hospital practices is quite severe。
The first one to make the path dependent is the american economist and sociologist douglas north. It is easy to understand that technological evolution or institutional change in human society is similar to inertia in physics, and that once a path is entered, it is possible to rely on it for good or bad。
The maximum diameter of rockets in service in our country is 3. 35 metres, such as long march 2 (c), long march 7. The width is determined by the tunnel of the railway. The rocket transport requires a railway, and the rail orbit standard of 1435 mm is determined by ancient rome using 4. 85 feet as the standard width of combat vehicles, while 4. 85 feet are determined by the width of the two horses of the tractor. This is the path from horse ass, to combat vehicles, to orbit, to rockets。
There are also many examples in the medical profession, such as, for example, treatment kits for non-surgery items such as lasers, which can be improved in a number of ways, but which have not changed much, and why? It was designed to be that way at the beginning, and the mold design, usage habits have been shaped and difficult to change。
Many surgical styles have the same problem if they are to be changed, and they have been written into textbooks, operational guides and, if they are to be revised, the workload and time costs they face will be far greater than can be imagined。
Path dependence means that people's decision-making choices under given conditions are subject to their past decisions, even if the past situation may have become obsolete. Broadly referring to the influence of historical factors; narrowly referring to the self-enhancement of the system, but at the beginning the nuances are gradually magnified, resulting in a disproportionate increase in subsequent situations。
What is more frightening is the self-enhancement of path dependence, which prevents change or improvement. Like that famous experiment: the story of monkeys and bananas in cages. As long as there's a monkey to feed the bananas, all the monkeys will be punished with a high-pressure water gun. Then a new monkey comes in, he doesn't know the rules, he stretches his hand to the bananas, and the original monkeys beat up the new monkey until it obeys the rules。
The medical business model is all the more path-dependent: high-priced customers, passive compliance, grey-walking, asymmetric games with channels, core technology instability, lack of firewalls and moats。
Strong marketing push, medical care for marketing, is a model that has been replicated throughout the industry, and although many people know its problems, no one dares to challenge it, which is typical of path dependence。
The 100-degree model of the early medical-american approach, which no one dared not bid for, is considered a necessary route。
For example, when low prices are introduced, since the tripartite electric platform became the main source of customers, its means have become more abundant, and many institutions have seen these approaches as a necessary way of doing business and few have gone the other way. It's just the few who dared to come the other way. They're doing fine。
When should we break the path? In the united states, for example, when the international organization for standardization introduced public units such as rice, kilograms and seconds, the united states continued to use british units, even though the organization had its headquarters in the united states. To date, there are also frequent academic articles in the united states indicating that hundreds of billions of dollars are lost each year as a result of the united states use of different units of measure from most countries internationally. This is an extreme example of path dependence. The reason why the united states did not adopt a metric unit was the resistance and opposition of the manufacturers of metrology tools when it originally planned to introduce international standards. Paths depend on, and are not used. Since it was not used at first, it is still not available. Since its establishment, the new china has benefited greatly from the comprehensive introduction of metrics。
Iv. Banam effects and survives: who should we learn from
The banam effect was tested in 1948 by the psychologist bertram fowler: it is easy for everyone to believe that a general description of personality is appropriate for himself, even if he is not at all, and that the description of a general person accurately reflects his or her personality; it is the same for businesses. This is an example given in the book " director of medical cosmetology in china " . Barnum is a legend in the history of the united states, whose most famous statement is: “direct propaganda, too. Nothing can happen without propaganda.”
The cause of the banaem effect is considered psychologically “subjective proof”. Caesar said a famous phrase: “no one wants to see the whole truth, and people often want to see only what they want to see”. People who want to believe in something subjectively can always find the evidence to prove themselves right. This subjective test effect, which often exists in the subconscious, is the bottom cause of our miscalculation。
Aberrations in the perception of successful people have made it difficult for bottom-up business models to emerge at the time when they were supposed to be, allowing practitioners in the real sector to pay fees。
There is a very famous story about survivors' deviations. In 1941, abraham ward, professor of statistics at columbia university in the united states, accepted an invitation from the navy to use statistical principles to figure out how to reduce aircraft losses. The generals found those returning warplanes with bullet holes on their wings and recommended that they should be equipped with armour on their wings. After careful observation, ward found that the aircraft with bullet holes on their wings were in fact survivors, and that they had been hit on their wings, without affecting their return, and that what really needed to be studied were those that had been shot down, which were truly worthy of study. He later discovered that once the engine had been hit, the possibility of returning had been eliminated and that, therefore, the engine should have been protected by armour. Those who focus on the wings are mired in cognitive deviations from survivors。
There is an old saying in china: only thieves are seen eating meat, and they are not beaten. This is also a deviation for survivors. We should really look at those who have failed, and their lessons are truly worth learning。
The most important aspect of health care is the cognitive error zone, which is mired in a survivor's deviation, where only the surviving institutions are seen, followed by a picture of the body, without taking decisions according to their own conditions and the characteristics of the city and market environment, as well as the technical characteristics of the doctor. Institutions that focus only on marketing and ignore the technical value of doctors or personal ips may have some of these problems。
What kind of medical model is destined to be eliminated
One of the reasons why the bottom logic and business model is not comfortable or even viable may be caught in the trap of thinking of the banhem effect and the deviation of survivors. This is often seen in entrepreneurship doctors. For example, some of the major doctors sit together and talk about how much surgery they can do in a year, and how many of their fans decide to co-operate in a clinic. As a result, less than six months later, resources were exhausted, there was no more funding and psychological preparation, and clinics were in trouble and even shut down and turned around。
To avoid falling into the trap of thinking, it is possible to properly assess and understand the resources at its disposal without drawing the wrong conclusions. If attention is paid to the bias of survivors and to the reasons for the disappearance of the missing entrepreneurship institutions, it will be possible to avoid many pits of blind optimism and ill-preparedness。
