A sentinel moment in physics was the discovery that light was both a particle and a wave, the wave-particle duality. (It was certainly a sentinel moment for me as this was the point when physics got to be a little too vague for me to clearly follow) Here is the Wikipedia explanation of the experiment:
“… a coherent light source such as a laser beam illuminates a plate pierced by two parallel slits, and the light passing through the slits is observed on a screen behind the plate. The wave nature of light causes the light waves passing through the two slits to interfere, producing bright and dark bands on the screen… the light is always found to be absorbed at the screen at discrete points, as individual particles (not waves), the interference pattern appearing via the varying density of these particle hits on the screen.”
We have a defined mathematical means of understanding particles, through quantum mechanics and waves, through classical mechanics. (The ‘we’ is rhetorical since I readily admit that quantum mechanics is beyond my conceptual framework). But in a fractal way, is this wave-particle duality not equally true for our behavior?
Are we particles? Certainly in the healthcare arena, we are individual actors with abilities to impact healthcare for individuals more than for ‘populations’. There are techniques to understand and structure our individual actions, Lean Six Sigma, the Toyota Way, any of the forms of operational management that choreographs our individual actions.
Are we waves? Well yes, in the sense that our individual acts can be aggregated with the acts of others, to create a synergistically greater accomplishment. The herd immunity arising from vaccinations, team care, service lines, care platforms address our wave function. Again, there are many techniques we can use in this setting, standardizing care through default behavior or order sets, evidence informed medicine, big data analytics, or predictive modeling in business intelligence.
Physic’s deep knowledge of our world as particle and wave cannot be reconciled with one another. They’re real, true, very different and difficult to reconcile. As Einstein wrote: " We have two contradictory pictures of reality; separately neither of them fully explains the phenomena of light, but together they do". This is physic’s continued quest for a ‘unified theory.’ My point is this is equally true for our behavior; sometimes we act as particles and at other times we act as waves and cannot readily reconcile how that occurs. Like ‘unified theory’, we search for an understanding to tie our particulate and wave behavior together. We use terms like the art of medicine or culture, which we all recognize but cannot define. The complexity of our individual interactions gives rise to our wavelike behavior.
Crowdsourcing may be a behavioral slit lamp providing insight into our wave-particle interface. The term describes “taking a function once performed by employees and outsourcing it to an undefined (and generally large) network of people in the form of an open call.” Kickstarter, which provides crowd sourced funding, is a great example of individuals ‘liking’ an idea into reality.
In medicine, PatientsLikeMe is a “platform for collecting and sharing real world, outcome-based patient data and are establishing data-sharing partnerships”. 23andMe is another. Two simple techniques, aggregation and collaboration, synergistically applied create a ‘platform’ to improve patient care. Paradoxically, the collaborative effort of individuals’ results in better individual care, wave and particle simultaneously. It is more difficult identifying a crowdsourcing example for physicians and other healthcare providers. In general, they facilitate collaborative diagnostics CrowdMed is an example. It seems that our aggregation and collaboration remains locked up in traditional curated models, e.g. peer-review journals or in hierarchal relationships.
We share physics’ conundrum unable to easily reconcile our particulate and wave behaviors. For physicists it is the search for the unified theory; for healthcare providers it is understanding how to share our art.