I had a dream last night. It went something like this: I was in a huge room filled with groups of people having heated discussions. “Red chicken feather soup is assuredly the best cure for cancer of the eyeballs,” I heard one of them say. “That’s not what I heard,” said another. “Ear wax dipped in guacamole and rubbed into elm bark works better.” “Nonsense!” said a third. “Neither of those things work. You need to FEEL the disease and ask it what kind of animal it would like to be.” At this point I couldn’t help but speak up. “What is your cure rate?” I asked. “Huh? Who are you?” they replied. “Just someone trying to understand your discussion.” “Cure rate? How are we supposed to know that? We just do our thing and let the patient do the rest. We’re professionals!” they said indignantly. “Okay,” I said. “Have any of you folks ever heard of pharmaceuticals? These are drugs that can cure most of the diseases you are discussing.” “You’re crazy. I’ve been using red feathers for years,” said one. “Wait a minute…you’re trying to sell these ‘farma-cuticles,’ aren’t you?” he asked warily. “No,” I replied, “I’m just trying to understand why you call yourselves professionals, even though you have no formal training in the field, reject all the science available to you, and persist on using silly practices to do serious tasks.” “Now just a minute, fella! We’ve been doing this for years and know everything there is to know about it!” “Okay. What are the Uniform Guidelines for good medical practices?” I asked. “The Uniform what?” “The Guidelines, you know, best practices,” I said. They seemed confused and started chattering among themselves. “Well, of course we do!” said one, with uncertainty in his voice. “Those guidelines are too much trouble. They take too much time. They only deliver average results. Besides, ‘practicing’ is not the same as ‘doing.'” “Okay. So you are telling me that best practices — the practices that help you cure the most people, treat every patient fairly, avoid being sued, and become a true professional — are too much trouble and only deliver average results?” “Yeah,” they said. “Your glass is empty. Don’t you want to go waaay over there and fill it up?” “No, I’m fine.” “Look, we really only care about whether our patients stay alive for six months to pay their bill. But we do have a problem with our apprentices. They are not very healthy and die fast. Would these ‘farma-cuticles’ help?” “Sorry, you lost me there,” I said. “Your own apprentices fare no better than your patients?” “Well, yes.” “So you are selling a service that is no better than patients can provide for themselves?” “You have us there. Ha, ha.” “What is your market advantage?” I asked. “We find and screen-out riff-raff patients.” “And then? “That’s it. After that, it’s up to the patient to either get better or die!” They all chuckled and glanced sheepishly at one another. “But seriously, we could use some help internally.” I left in disgust and walked over to another group that was also actively engaged in heated discussion. “…the damned patients get sick and cannot work. They die and we have to replace them continually,” I overheard one person saying. “Hello,” I said. “Who are you?” “Like I told those other guys, just someone trying to understand what’s going on. What’s this about your patients? You sound frustrated.” “Frustrated? Frustrated? We can’t get a patient worth a damn. They all look healthy when we hire them, but about half get sick and die. It costs us a fortune!” “Sounds like a problem,” I said, “what are you doing to make sure they are truly healthy when you hire them?” “Well, we talk to them for about an hour. Sometimes we even ask if they are sick.” “What do they say?” “Just what you expect — they are perfectly healthy and promise not to get sick.” “So you believe them?” I asked. “Yeah, why not?” “Do you do any tests? Blood pressure? Pulse? X-rays? Physical exams?” “No. That takes time.” “But you were just complaining about the problems this causes.” “What’s your point?” “You complained your hiring system is costing a fortune,” I said, “but you don’t do anything to improve it. In fact, it seems like you prefer to argue about the consequences than fixing the problem.” “Your glass is empty. Don’t you want to go waaay over there and fill it up?” they asked. “No, I’m fine,” I replied. “Well, hotshot, I suppose you have the answer.” “I do. Do tests. Check blood pressure. Take their pulse. Give some X-rays. And do a physical exam.” “But that would take time, and, um, it would interfere with our gut reactions.” “But time and gut reactions are not working for you!” I said. “What’s your point?” Brrrinnnggg! I woke up with a dull headache. What did it all mean?