If I could trade places with one person for a day, it would probably be
Anthony Bourdain. His shows allow him to
travel to far flung regions and showcase culture beyond the landmarks. Wrapped in beautiful cinematography, he often
goes below the surface to uncover engaging people and stories better than any
other travel show. This past rainy weekend
was the perfect opportunity to catch up on his recent trip to Paris, which showed
a contrast to the US that I haven’t been able to shake.
One of the episode’s recurring themes was the newish trend of
brasseries focusing on local, sustainable products, pushing aside traditional
French recipes and preparations. To accommodate
this shift, many of these restaurants had prix fixe menus that changed daily, a
concept Parisians were tolerant and accepting of. This is no small task, since it requires diners
to enter a restaurant blindly and trust that the chef will deliver something
memorable.
A similar concept crossed my mind a few years ago when I visited Europe
and was shocked to find art museums handing out iPods to visitors as audio guides. It struck me that there was an implicit handshake
between the museum and its visitors saying that the iPods would be returned unscathed,
something that I couldn’t imagine seeing in the US at the time.
We may have iPods in museums now, but I believe we see less of this
trust between authority and individuals in the US, substituted for rugged individualism
and a need for personal control. To
illustrate using the restaurant industry, look first at the fast casual concept,
which has experienced huge growth over the past few years. Their business model (use Chipotle as an
example) is that the customer can create and customize their meal however they
want, no questions asked. Many
restaurants also now have open kitchens, allowing the diner to see what goes
into their food preparation. Finally, there’s
been a big debate in the food community about substitutions, with many saying
that chefs must accommodate a diner’s request even at the fanciest restaurants. In all these cases, rather than trusting the
chef or the kitchen, the diner has seized control back into their own hands.
While you can see this everywhere in the world, I think there’s a bit
more of this in the US, the result of capitalism and our unique history of
self-sufficiency. We have been taught through
history classes and the media that we need to act as an individual and control as
much as possible, not letting others dictate how we should think or, in this
case, eat.
I believe this ethos also extends to healthcare. Recent areas of innovation have been focused
on consumer empowerment as we plod towards exchanges and the internet becomes a
bigger source of medical information.
Putting aside politics (e.g., the wisdom of the single payer system), is
this a good trend? Put another way, is our
fear and mistrust of central authority, combined with the democratization of
the digital age, a good thing for the US health system?
Think about the challenges a doctor faces. After four years of med school, four years of
residency, and countless more years practicing, patients now feel “empowered”
to undermine, or worse ignore, a diagnosis or treatment. At a higher level, I see this every day when
our customers want us to customize our member engagement campaigns, outreaches
that have been tested and tweaked to maximize their effectiveness. Rather than trusting our approach, our country’s
staunch individualism has made evidence and expertise seem like a bad thing.
Since when do we know better than experts? In order for consumerism to be successful, I
think we need to figure out how to marry up expertise and individual decision
making so that we make the right decisions.
This starts with a fundamental conversation about our culture and authority
– maybe in this case we need to be just a little more French.
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