Learn the Secrets of Wilbur and Orville

As we celebrate the 100th anniversary of theWright brothers' first flight, it's fitting forhigh achievers like doctors to think aboutwhat these inventors accomplished andhow they did it. The Wrights were unlikely heroes,outside the mainstream scientific and engineeringestablishments in their day. They were just a couple ofguys with a bicycle shop in a backwater town. Butthey had a dream. They backed up that dream withdetermination and solid scientific and engineeringresearch. And they were stunningly successful.

For thousands of years, people's desire to conquerthe air had been frustrated repeatedly. When theWrights started their quest for powered flight, humanitywas stuck on the earth, trapped on the ground.When they finished, humanity could soar into theheavens and the future was profoundly changed.

We doctors certainly know what frustration is. Weoften feel trapped, though in a different way. We'retrapped in a dysfunctional health care system, stuck ina rut of endless demands from insurance companies,patients, government, and lawyers, who all seem tocounter our main goal of caring for the sick. Ourdreams of being free to care for patients as they oughtto be cared for seem virtually unattainable.

The WrightBrothers and the Invention of the Aerial Age,

If we could only discoverhow the Wrightsprevailed over seeminglyinsurmountable difficulties,maybe we could beempowered to solve ourown problems. Let's goahead and ask them fortheir advice. Don't laugh.Haven't you heard that space and time are relative?Intertemporal interviewing was only a matter oftime. I prepared for the interview by reading anexcellent biography of the Wrights, byTom Crouch and Peter Jakab (National Geographic;2003). I caught up with the Wrights in Paris in theyear 1909. Here's how it went:

Be Clever and Innovative

Constan:

Gentlemen, we in the 21st century arestill enthralled by your achievement. Could youenlighten us with the secret of your success and giveus some ideas as to how we can solve the dilemmadoctors are in today?

Wilbur:

We brought fresh thinking to humanity'sage-old yearning to fly like the birds. The establishmentwas locked in their old ways, and couldn't seethat new approaches were needed. When werethought the problem of powered flight, we discoveredthat we would need to solve three problemssimultaneously: lift, propulsion, and control. Afterthat, it was only a matter of time, disciplined effort,and good science before we solved the problem.

Constan:

I see. You're saying that maybe we doctorsare not as innovative as we need to be, and thatmaybe we're actually part of the "establishment."Perhaps we get indoctrinated during our training todo things a certain way. Maybe new ideas for managingmedical practice, such as learning how to delivercare outside the traditional hospital and office bytelephone and the Internet, don't come fromWashington, DC, or the big medical centers, butrather from the little guys in lesser-known places likeKokomo, Ind, or Saginaw, Mich.

Be Persistent

Constan:

You worked on your problems a longtime before you developed solutions. Didn't you everbecome discouraged and want to give up?

Wilbur:

We believed that we must never give up onour dream. It took us almost 5 years of constant effortto make our first airplane, and then 5 to 6 years to setup the legal and business infrastructure to start marketingit. But we persisted and attained our dream. Ifa dream is worthwhile, you must never give it up.

Constan:

So you'd say the fact that doctors havebeen working on the liability problem for a couple ofdecades is not that big a deal, as long as we eventuallycome up with a solution. The same applies to theother big problems in medicine: There must be solutions,but it may take a while to develop them.

Communicate Well

Constan:

But what about your detractors, the oneswho had other ideas about how to fly? They scoffedat your plane and didn't believe it would work.

Orville:

At the time, it seemed that their solutionsto powered flight should work as well or better thanours did. We didn't know for sure, but we realizedthat we would have to demonstrate our plane to asmany people as possible, so we took our show on theroad. In the end, enough people had personal knowledgeof our success and saw that the other solutionswere inadequate.

Constan:

So, if we were to apply your advice tomedicine today, you'd say that we can't just proposeideas for solving our problems; we must also communicatethese ideas to a lot of people, in all walks of life.Most people are patients at one time or another in theirlives and want to be able to trust a physician to makethe best decisions for their health. Therefore, we shouldbe able to convince them that we have the answers.

Avoid Distractions

Constan:

Unfortunately, I see a big problem withapplying your ideas to the present day. We doctors mustpractice in a system that demands that we have bigoffices with multiple staff members to handle insurance,scheduling, and charting. We're spending all of our timeworking to make enough money to support that infrastructure.How can we have time to innovate?

Orville:

We have a small staff at our factory inDayton, Ohio. Everyone knows everyone else andwhat each person does in the factory. The technologywe're dealing with is very complicated and easy tomess up. We absolutely must work together to get thetechnology to work properly. I don't think you doctorshave ever understood this fact. When my planecrashed a few months ago, I broke a leg and severalribs and had a concussion. I saw several specialists,each of whom was focused on their own area, so theydidn't always tell their staff and the other doctors whatthey were thinking. My care was very disjointed. Youdoctors need to find a way to attain a level of cooperationwith each other and stop worrying about yourown problems rather than the patient's.

Wilbur:

Let me say something else about makingmoney. We're trying to change the world, and wedon't have time to focus on our incomes. It's the quality,not the quantity of work you do. In the earlyyears, we only made one plane a year. Perhaps 21stcenturydoctors could stop worrying about theirincomes and focus more on their work quality.

Constan:

One last thing, what about retirement?Certainly you'll agree that we need to make a lot ofmoney to provide for our retirements.

Wilbur:

Why do your readers want to retire? Aren'tthey happy with what they're doing? Orville and I intendto keep working, doing what we love, until we can'tphysically continue to do it. Then, maybe, we'll retire.

Constan:

I'll let you two have the last word. What'sthe bottom line? What would you like to say to ourphysician-readers?

Wilbur:

Be creative. Don't be discouraged that you'renot recognized as a leader in your profession. We'velearned that even the little guy can make a big contribution.Look for new approaches to old problems, be persistent,never give up on your dreams, and don't stop tryingto bring others into your dreams. Who knows, yourefforts could, as ours did, set off a revolution that radicallychanges the world in the next 100 years.

Louis L. Constan, a family practice physician inSaginaw, Mich, is the editor of the Saginaw CountyMedical Society Bulletin and Michigan FamilyPractice. He welcomes questions or comments at3350 Shattuck Road, Saginaw, MI 48603; 989-792-1899; or louisconstan@hotmail.com.