Of greater moment is how to orchestrate evidence-based health care when the journal articles come so fast and furious that no sub specialist can keep up with her own, let alone those of all the other sub specialists. How do you keep medicine from becoming a Tower of Babel pinball machine, and patients the pinballs? And what’s a generalist, i.e. primary care physician, supposed to do? How do the clinicians militant help a patient work his way through a diagnostic decision tree to the right treatments for him — when everything in medicine is freighted with probabilities, trade-offs and side effects that shift like Hogwarts’ staircases depending on the morbidities you happen to have? Remember, our most expensive folks tend to have several.

Just because for every action there’s a reaction and nothing in life is certain but death and taxes, our priests of medicine do have explaining to do to internet savvy consumers (us) who should have a say, perhaps the final say, in our own care. Our culture is moving that way so sayeth Deloitte and just about everyone else. Health care should be wired up, clinicians and patients hip and joined at the hip on line, so sayeth Gates and Google. We do have an emerging consensus on pretty significant matters. Still, the pros have work to do to fashion a user-friendly interface for the burgeoning tool kit of medicine, and we the consumers have work to do too. Being deft with a mouse doesn’t make us savvy; what makes us savvy is knowing how science works — rules of evidence, scientific method etc, and what science yields — probabilities not certitudes — and that all health care is a balancing act that works a whole lot better if we work to stay healthy. Today’s health care disorients us, some of us more than others. For us to get our bearings, this industry must clarify, which in fits and starts it appears to be doing. Once it gets there, we’ll all have a better idea of what we think and what we want.