“For the strength of the Pack is the Wolf, and the strength of the Wolf is the Pack.”
—Rudyard Kipling, The Law of the Jungle
The interdependence of a community and its people
As Americans, we tend to focus on the power of individuals when in fact, what makes every one of us strong is our community. To understand this, imagine the most resourceful person you know. Then imagine he or she is stripped of anything made by another person; no tools or clothing – nothing! For this experiment, we want to test their singular capability to create prosperity alone.
Next, they are taken to a wilderness far from civilization for an extended period, say a year, to fully prove their greatness. As everyone knows, few will be lucky to survive. The plain truth is, we aren’t much without the interconnecting web of interdependency we call community. Community is the source of whatever power and strength we have. High performance individuals excel though access and use of social systems and resources.
The power of the multiplier effect in a community
Communities interact internally and with other communities. Because these interactions also involve feedback loops, any change has the potential to create a cascade of other changes. For any given change, we cannot understand how a system will react, but over time, this propensity to create multiplier feedback loops is at work. And this can work for or against us.
Feedback loops magnify both success and failure. Every person’s success depends on the community and the community’s success depends on its people and their relationships. Strong communities make success easier for people and failed communities make success doubly hard.
What this means for healthcare
If healthcare is to serve patients well, we must understand and use the feedback loops that are active in the community. These feedback loops go beyond traditional medical care and include dental health, behavioral health, public health and social services. By including these community feedback loops in our overall assessment and treatment of each person, we can achieve higher quality at lower cost.