The much-quoted line “Patients are the most under-used resource in healthcare” was first uttered in the 1970s by Warner Slack, MD, when he was a young doctor in Madison, Wisconsin. It’s seen many versions and incarnations since then, but it all started with Dr. Slack’s feeling that patients could help a lot by directly entering the basics of their medical history directly into the computer.
And last night I found a video of the first TV show about this idea – from 1967, a full half century ago! That’s him, on the right. (Check out the keyboard his right hand’s resting on.)
It’s from a public television program, back when PBS hadn’t even been created yet … back then it was N.E.T., National Educational Television. The program was part of NET’s new “Spectrum” science series, and was titled “LINC” with Tomorrow. (LINC was Laboratory INstrument Computer, and was a direct ancestor of what would become the PDP series of time-sharing mini-computers from Digital Equipment Corp.)
An article in yesterday’s Boston Globe, Patient Power through Records, features Dr. Slack and quotes extensively from the show, which tipped me off to go hunting. Part of me wants to paste in all the notes I took while watching it, but I’ll leave that to you. Broadly, here are the sections:
- Opening: defining the problem the show is about. Here there are some quotes I had to laugh out loud about – the challenges physicians faced 50 years ago.:-)
- Demo: Dr. Slack explains how it works to producer Dave Prowitt, and then has him enter his data, shifts to doctor-exam mode, and ultimately sends specimens to the amazing computerized lab machine, which sends the data back to LINC!:-)
- Thoughts about the future. A half century back. Think about what’s changed and hasn’t.
Readers who are in your early careers: you’ll probably be around a half century from now, to look back at this, as we’re looking back at that video. What do you predict, as Dr. Slack did then?
If you’re a history of medicine buff, here’s some related reading about that era:
- This show appeared just as the famous Dr. Larry Weed was introducing his Problem Oriented Medical Record. Here’s our post about it, with video of a 1971 lecture he gave – that’s a hoot, too. (Check out the overhead projector.)
- The POMR was world-changing, because believe it or not, until then there was no standard way for doctors to organize their notes!
- Here’s our 2011 post Lawrence Weed, father of the Problem Oriented Medical Record, looks ahead
- In this 2008 post, SPM co-founder Gilles Frydman has some some fascinating Weed quotes about the patient-provider relationship, e.g. “The unaided human mind is not a reliable instrument for this processing of information in the solution of patients’ problems. It should not be licensed to try the impossible.”
- The show’s producer / interviewer Dave Prowitt went on to win an Emmy in 1972 for the “Pentagon Papers” PBS Special.
- From his bio at the U of Maryland library:
- As a correspondent in Vietnam filming for the NET series “The Borders of War,” Mr. Prowitt became the first public broadcasting reporter to broadcast from a combat zone.
- Prowitt’s other endeavors at WNET included developing “This Week with Bill Moyers,” and “Bill Moyers Journal.”
- This show was part of Prowitt’s WNET science series “Spectrum,” which later turned out to be a competitor to a new science idea from WGBH in Boston: Nova.
- From his bio at the U of Maryland library:
I’m capturing this update here in a comment so I don’t lose it.
Everyone I know has always quoted Slack as the source of “the most underused resource,” but last year on Twitter I learned that others first heard it from Don Kemper, founder of Healthwise. And tonight I found this slide deck of his on the National Academy of Medicine site. It’s undated but must be from the ~2015 era since it talks about the Meaningful Use health IT policy of that period. https://nam.edu/wp-content/uploads/2017/11/Don-Kemper.pdf
In the slides Kemper cites Vern E. Wilson MD https://snaccooperative.org/ark:/99166/w6rz3cbg as the source of the line. Wilson was an undersecretary at the Department of Health Education and Welfare (precursor of HHS), and as a young lieutenant in the US Public Health Service, Kemper saw Wilson speak in 1970: “The greatest untapped resource in healthcare is the consumer.” The same is on slide 4 of this long deck https://www.yumpu.com/en/document/read/33018767/download-a-133-mb-pdf-version-of-the-presentation-patient-
Whoever said it first a half century ago, this is not a new idea, yet anytime someone says it on Twitter or at a conference the audience is surprised. What the HECK, people. I wish we’d get off our duffs and update ALL our practices to tap that untapped resource!