Not only is Daniel Pink the man, whomever did the marker drawing is pretty frakkin' amazing, too.Doctors: motivated by money? Change their behavior by carrots and sticks, alone? Not nearly so much as you'd think -- witness the still low rates of adopting electronic medical records, despite major subsidies and financial incentives.But publish their achievement scores over time where they and their colleagues can see them? How good they've been at improving, and how they compare to their office mates? Watch the curves bend!Most physicians are intrinsically motivated by an internal standard of merit, with scorecards built into their DNA. Who survives 4 years of grueling pre-med undergrad work, 4 more years debt-building med school, and 3-9 more years of residency training at ridiculously low wages? Not folks motivated by money -- you've got to be able to survive and thrive on how you score and perform.We've all pursued things that made no sense from the standpoint of basic loss and gain. This video -- a 10 minute snippet summary of Pink's book, Drive-- explains why.
Another morning session with Xeno at the Iron Oarsman. Not the most death-defying MetCon workout I've ever had, but spent most of the 45 min class close to my max HR, and definitely felt gassed in the last few minutes. Xeno managed to keep the session balanced between warmup, technique focus, interesting intervals, and getting delicately smoked.
Really liked the 10 or so minutes afterwards, just "paddling" (probably because of what ended immediately before). Went from 17 strokes/min up to a more comfortable 20, feeling the coordinated whole body ease of it; HR was in the 140's, so even that was technically high intensity cardio. Am sure I could learn to throttle it back, probably by having less water in the WaterRower's tank for resistance. How do you gauge how much water to put in the tank?
Got to try the Concept2; gotta admit, it felt nice, probably due setting it on a lower dialed-down resistance, plus the rounder handle cross section. But my Xeno model WaterRower is on its way, and it's definitely more pleasant in its liquid swoosh, what I'd imagine a scull on the water sounds like. The chain sound isn't unpleasant on the C2, neither is its soft airfan whir, which may actually be quieter than the water moving away from the WR's tank paddles. But the C2 is definitely more gym equipment in construction and feel, and would not fit our home. And I refuse to row a fan-based machine in the garage.WaterRower's website lacks robustness, compared to C2's. It's focused, but doesn't feel as full and inviting, like you could learn everything you wanted about indoor rowing from it, short of having a machine. I hope the company does well in other areas, because I'd hate to lose mechanical support down the road if its lesser Internet presence causes it to tank.Certainly am hoping that Xeno's efforts can create a viable meeting ground to fill that niche...and that WR will come around.C2 is the standard for competitive indoor rowing ranking. There are ways to offer something similar for WR; these should be learned from, not copied. The most unoccupied niche seems to be fitness for the new rowing enthusiast focused on other things besides competing.Look at pedometers; there's an immediate thrill from seeing those steps really add up. A walk around the block adds hundreds of steps to your daily total, typically shooting for the magic 10,000 mark. The meters rowed statistic functions similarly, like today's session + the 10-ish minute paddling: 13,018 meters. You can rack up the meters, time rowed, HR and time, torque, and stroke rate, or any combination. Offhand, meters rowed feels the most tasty, with the HR + time being a close second in terms of sensibleness. Just like walking/treadmill cardio for fitness, and the pedometer + HR & time.Online logging definitely adds something, tho'. Especially with new or virtual friends/training colleagues.Hey, hear that sucking sound? That's the whirlpool of communal, tribal proof and competition calling.It's a frakkin' siren call, is what it is. An easy Charybdis to fall into and get lost. It can be surprisingly hard to resist the pull of a thankless, seemingly left-field niche, filled with the earnest young and young at heart, training and competing in extremis. With hundreds of years of cachet and tradition. That describes rowing, sailing, and most traditional martial arts (guilty as charged). Remember why we came here:
Alternate continuous session cardio to cross train with walking/jogging/running
Joint sparing, even at high intensity levels
Quiet, doable at any hour without waking family
Potentially meditative, or soothing
Fits in within the home decor (only not an issue if you are Single with a capital "S")
Still planning on doing 1 hr most days of cardio...would like it to be 30 min of moderate walking/jogging/running, and 30 minutes of moderate rowing. And 20-ish minutes twice weekly of high intensity rowing (plus strength training).
Why? To keep weight in check (more about food choices, but no question 70 min total/day of cardio helped), bp under control without meds (so far, so good!), and stress relieved. Plus hopefully all those other wonderful fringe benefits -- mainstream benefits, really: longevity, emotional stability, anti-aging, dementia risk chop down, brain neuron growth and complexity increase, improved learning and memory, antioxidant production. And so on.Competition is nowhere in there.But tracking numbers and comparing some can help keep the motivation up.Then there's Daniel Pink's Third Drive.Which is what a bit different from what I'm talking about just above; it's about the intrinsic value of the activity itself, as opposed to a reward you chase, or a punishment you avoid. Rowing, you can really find a groove, the groove, pretty easily, if you're not intent on "hammering it." That's a nice place to be -- stay awhile, then maybe play with things a little. Then it can seem fun to cruise towards certain target goals, as opposed to being driven by them.That is the dog, with the rest being the tail.
Groundbreaking stuff from just a few years ago, that's withstood the test of time.
A new, larger segment of the economy, based on right-brain creative and innovative activities? Check.
Increased outsourcing to overseas talent as digital communications break down walls? Oh, absolutely Check.
That's already happening in medicine, with medical tourism -- notably, to the wonder clinics in Thailand. And as Dr. Davis Liu points out in his article, it's even happening with radiology interpretations, with the images being beamed out to be read in Australia and India, for 1/3 our cost.
Do globalization and tech translate into primary care medicine becoming THE most solid career choice for future doctors?
Maybe. There's only so much you can ship overseas, and travel is still kinda pricey. Someone will have to manage everything that you can't ship out, or manage by e-consult -- the primary care docs, Dr. Liu posits.
Pink argued that you want to get thee hence, pronto, to a line of work that isn't easily replaceable, via technological advance and global outsourcing. That has invaluable, unmatchable experience on the ground that simply can't be appreciated or implemented somewhere else.
Essentially, that can't be rendered down into a commodity to be bargained down, or digitized and handed off.
I'm just not sure that primary care medicine entirely fits that bill -- much of what PCPs do can be done more cheaply by nurse practitioners and physician assistants, and so is subject to commoditization forces. But if PCPs evolve, they can also take on tasks that were previously in the purview of specialists, so it's kind of a wash.
There's no substitute for reliable, capable eyes and hands on the ground; there will always be a niche, and a demand, and a need, for primary care physicians.
If we can just get the word out to med students, who have been running in the opposite direction for years, and survive the next few transitional years where the medical demand outstrips the PCP supply, we ought to be just fine.
