Living in a Box and Trying to Think Outside of It

After reading Victor Papanek's chapters, I felt a little bit conflicted: conformity versus creativity (evidence-based decision making versus 'thinking outside of the box'). He explains that finding oneself at one extreme or the other is not what he's advocating, rather he asserts that:

"In fact, conformity is a valuable human trait in that it helps to keep the entire social fabric together. But we have made our severest mistake in confusing conformity in action with conformity in thought (135)."

After Matt Holloway's lecture last week, "everyone is a designer"--regardless of one's profession, at one point or another, we have designed something. So Papanek's argument applies to all fields and professions; however, recently there has been increasing emphasis placed on evidence-based management and decision-making in health care. What I am having trouble compromising is that I see value in both approaches to problem-solving--I wonder how it is possible for aspects from each approach to inform the decision-making process in dealing with a health care problem or issue, for example. While one never wants to continue to 're-invent the wheel' in making decisions and solving problems, at one point does one stop trying to develop innovative solutions in trying to resolve a particular conflict? When does one decide to ignore the practice of 'thinking outside of the box' simply to focus on surveying what has been done in this field (and other fields) when faced with the same problem? Taking into account the time constraints that people face day-to-day also skews this decision-making process towards choosing a 'solution' that's has been proven to be efficacious because it is much tougher to 'think' than just 'do' when 'time is money'.

Moreover, in this respect, I totally sympathize with Papanek's assertion that our society and educational system encourages and rewards conformist thinking. Today, we live in such a fast-paced, results-oriented world where the incentive structure is set up such that tangible productivity is rewarded while intangible productivity (or simply thinking) is penalized. I've seen this occur in practice numerous times when people rush into creating and implementing an intervention to meet a social need without the proper assessment and analysis carried out to ensure that the intervention is (a) effective and (b) sustainable after the intervening team leaves just so that something is being done. However, as I (and I'm sure many others) have witnessed, sometimes less is more, especially when the intervention could do more harm to the target population than the current status quo.

What I thought was especially interesting was that his observations are as relevant today as they were in 1970. After reading Papanek's chapter 7 regarding this tension between creativity and conformity and the numerous blocks that inhibit us from even developing solutions that are innovative (let alone being able to implement them on a larger-scale), I began to think on how this could be undone for me personally (since I have been conditioned to stay within the box as a consequence of spending a majority of my life in academia). Personally, doing more exercises as outlined in Robert Harris' "Creative Thinking Techniques" I think would be very beneficial--however, what I've discovered is that I still succumb to attitude that in order to be productive, I must be able to furnish palpable evidence of my efforts. In other words, while trying to sit down and flesh out an example Harris proposes to help people start thinking of unorthodox uses for simple objects, I find my mind wandering to the mental checklist of things I must do that inevitably results in me deciding to focus my energies on another task that allows me to show what I have accomplished (such as writing in this blog, for example!). In other words, trying to find a balance between conformity in action and conformity in thought is difficult if I have been trained to operate as if they were one-and-the-same.

With that, I realize that years of conditioning to producing tangible results will not disappear in a day, a month, or even a year. Nonetheless, I am hopeful that recognizing this tendency is one step in thinking beyond this box in which I reside.

A Late Start

Although I've missed three of the last four sessions for this Social Entrepreneurship class, I was still graciously allowed in--much to my excitement! It's interesting how paths change, especially in so little time. Just a couple years ago I was searching for THE perfect graduate program that would allow me to do a Peace Corps stint while getting my Masters'. Back then, international health was THE only way to go for me. I had traveled, studied, and worked abroad and I was so in love with the notion that I could combine my professional and my personal interests of exploring and traveling all in one nice little package. However, my direction was changed when trying to apply for paid fellowships/internships abroad. I realized that most people receiving these positions either had a Masters' or a Bachelors' with a lot of work experience. Unfortunately for me, I had neither since I was just coming out of undergraduate study. So then began the search for the perfect graduate school since taking more than one year off from undergrad was not something I was interested in (nonetheless, it was a fantastic year off!).





Fast forward a few years and here I am now at UCB finishing up my degree in Health Policy & Management--basically, the farthest concentration from preparing one for an international career. My rationale, however, was very much a pragmatic stance on how to best prepare myself for my professional development: did I want to focus solely on international health to the exclusion of learning more about our domestic health and health care situation? I realized that in order to become a manager/leader in health and health care abroad or here in the US was that I would need to develop very practical, 'hard' skills. Thus, the reason why I only applied to Health Policy and Management programs (although I would say I'm more 'Health and Social Behavior' for those in the know of Public Health concentrations).





So with one year under my belt (time feels like it has flown!) I'm deep into the domestic health care system, but it's funny because I really enjoy it. Although I'm not focused on the marginalized populations abroad, I'm basically working in the same arena except for the fact that I now focus on marginalized populations within the US. Nevertheless, I'm excited to continue to learn and discover about innovative ways to hep alleviate the suffering of the impoverished because I believe that the knowledge and skills used abroad could very much apply to the domestic sphere as well. I envision my professional career to develop in such a way that I will get the opportunity to work abroad and return to my initial public health 'roots'. I look forward to eventually translating my domestic learnings to the international sphere.