I have been following Daniel Schmachtenberger and his work on the Consilience Project and global catastrophic risks for some time. When I heard his conversation with Zubin on The ZDoggMD Show, I asked Zubin for an intro so that I could invite him to participate in our annual Hint Summit


During our conversations where we were planning for our Fireside Chat session at Hint Summit (watch the conversation here), I also shared with him key themes from my keynote on ‘A Light in the Darkness’ (watch full keynote here), and I asked if he had any thoughts. I felt that his perspective would be valuable considering the work he has done as a researcher on the design of systems and their effects on human civilization.


After one such session Daniel left me a voicemail of his thoughts and I found them to be both profound and moving, and so I decided to include the full transcript as part of my keynote presentation. I often get a little emotional when sharing things from the heart, and found myself pausing several times when reciting these words during my keynote especially when referring to the sacredness of the doctor-patient relationship and in restoring the spirit of medicine. 

Therefore, I’d like to include those words here as they truly resonate with the vision and hope that I have for fundamental change in the health and well-being of humanity through the scope of redesigning the healthcare system by accelerating the adoption of direct primary care.


Regarding your talk on a light in the darkness…


You suggested connecting that to the systems idea, where you can’t just fix one thing but also need to fix these other things as they are all interconnected and you can’t really fix any of them if you don’t fix them all. That sounds like the minimum project is a lot, it is a systemic fundamental redesign…and the idea that you don't need a floodlight, you just need one candle, seems like the opposite kind of sense - that just one simple little thing gets it started…so those two messages can seem incongruous. Of course there is a way to relate them, but you have to do the work to relate them. 


Healthcare is a complex system, and there are many aspects that have to change in terms of how we do diagnostics and interpretation, fundamental medical research, medical paradigms, funding paradigms of insurance, pharmaceuticals, hospitals, regulation, food systems, etc.


While all of that is true, what is foundational to medicine, and what could move the spirit of the whole thing in the right direction, is the doctor patient relationship being a sacred relationship that is supporting the life and aliveness of the human being… and someone having a profession whose life is dedicated to being in that sacred contract with other people. 


[As] opposed to the insurance model and the hospital administration models that have intermediated things to the point where patients don’t really have the depth of relationship with their doctor any longer, where their doctor is no longer making their choices with them. Instead, patients have a relationship with an insurance plan that will shunt them to different doctors, limit what the doctors can do… and they have a relationship with a market of expensive for-profit options where they have to weigh their possible health issues against their ability to support their life and family.


Having those considerations at the center is very different from having a sacred relationship of healing at the center. Who is choosing and interpreting diagnostics, who is overseeing the medications, who is working with the patient to make consequential decisions about their life that involve real uncertainty? Ideally that should happen largely in the context of an enduring and deep primary care relationship. 


And the fact that all these doctors and innovators, the ones that have already joined Hint and this community, and who on their own have gone to a direct primary care model, and who all seem to have in common a desire to move the money, insurance, administrative and legal arrangements out of the center, tend to them in a different way, and move the relationship of the doctor and the patient, and the sacred contract between them, back into the center, is profound. And that if this becomes the center, that center will be able to move everything else, all of the other aspects of medicine, which ultimately have to work through this center, and so the integrity of that center is fundamental.


And if you feel that this community of people are committed to this, even in the presence of the formidable pressures - financial, regulatory, status, and everything else that is pushing in the other direction - because they are actually committed most deeply to their sacred oath, and the experience of their patients, then they are the light, the candle in the darkness that has the ability to be a fundamental mover of the whole complex web of things that need to happen. - Daniel Schmachtenberger, Founder Member of The Consilience Project.


The Consilience Project publishes innovative research exploring key challenges and existential threats facing humanity, the underlying problems with current approaches for addressing them, and outlines how social systems and institutions need to be redesigned for the continuity of free societies.