Know – Part 1
No word surpasses know for instigating predicament. In general, what we think we know is: a) a matter of fact, b) a matter of policy, or c) plans of action. For ‘a’ we use the verb “is”,…for ‘b’ the verb “should”,…for ‘c’ the verb “will”. Examples: a) Mexico is south of Canada, b) freedom of speech should always be a basic right, c) our CQI efforts in healthcare will improve markers of population health.
George Boas (a historian of ideas) points out that ‘b’ and ‘c’ require the essential truth test of: 1) there is a problem in the present system, 2) the policy or plan does or will reduce the problem, and 3) the policy or plan will not introduce new problems. Note ‘a’ is not always incontrovertible either as best exemplified in quantum physics,…..e.g., light must be a particle or a wave,……in reality it is both.
Maybe we should heed the British empiricists – every word we use should correspond to an idea, and every idea should correspond to an actual experience. That is, we will be clear in healthcare that we do not know much at all, rather we have plenty of ideas. And Goethe observed “We are never more opposed to an idea than after it is rejected as one’s own.” So, it doesn’t take long to see how meager our knowledge of diagnostics and therapeutics is (esp. the latter). But, we do know unfavorably low socio-economic status harms pregnant women, the fetus, and the child (see Lu et al attached),……and we know heroic noble pioneers inspire us (see Dr. Crumpler bio attached).
Joe Kaempf, MD
District VIII Oregon Representative
Portland, OR
Volume 13, Number 11