We all know it’s hard to prove a negative. The term “Absence Blindness” refers to a concept that when you prevent something from happening (absence) it is difficult to perceive it. In our culture, there is more willingness to deal with something once it happens (Hurricane Sandy relief), then to prevent it from happening (mitigating sea rises through climate change solutions or sea barriers.) Similarly, though in Chinese Medicine, the art of prevention was considered the corner stone of a good physician, in our culture there is NO value placed on it whatsoever. It was hoped that with health plans like Kaiser, the costliness of a sick patient base would spur better preventative care. Kaiser definitely stepped up, but those savings are quite difficult to track. Absence Blindness. This concept was brought home to me while reading a book called “The Personal MBA” by Josh Kaufman. In the chapter on “The Human Mind” he states
Absence Blindness makes prevention grossly underappreciated. In the case of the Product I was working on (a product that prevented things from getting dirty), people had a hard time believing that something they couldn’t see working was actually effective. If you’re trying to sell the absence or prevention of something, you’re fighting an uphill battle, even if your Product is great… Absence Blindness also makes it uncomfortable for people to “do nothing” when something bad happens, even if doing nothing is the best course of action. Often, the best course of action is to choose not to act, but that’s often difficult for humans to accept emotionally.
(He, unfortunately goes on to say that if you’re in a business of prevention, get out. D’oh!) But this encapsulated for me what I see on a daily basis. Patient’s 6 month back pain goes away after 3 treatments. He says “Well I think it was going away anyway.” How to make this visible so that he values the treatments? Or more important, my patients who come in on a maintenance basis for hypertension, or allergies or migraines. THEY are convinced of the benefits, their allergies stay gone, they get very few colds, their blood pressure stays low, no migraines. But these patients are the rare exception in being able to see the benefits. So how do I convince patients’ of the benefits of what’s NOT happening to them? I think that has been my whole quest, to illustrate that there can be a downside of “doing something” like surgery or medications. We are seeing the trend by physicians and their panels to DO LESS for better health. That the gentler, more gradual approach of acupuncture, getting your body to heal itself, can be profound. The stress reduction provided by acupuncture is one of those benefits that is subtle but real. But, I also realize that my interest in HRV as a monitor, part of the quest to “make the invisible visible.” To be able to quantify and show. And though it can be seen as applying technology to something that is organic and natural and hence, in some circles, heresy, I would venture to say that my intuition is correct. People want to see. If the prevention can be seen as the building up of the system, the stabilization of the system, that is easier to see, to buy in. And, if the telomere technology is what is suspected, that may be another way to show prevention, or anti-aging as a positive, something to see, rather than the absence of a negative.