The Electric Mower of Our Future


Futurism is a long-forgotten artistic movement that sadly has been disentangled from its hero, Italian poet Filippo Marinetti, who in the early twentieth century took the time to write the Futurist Manifesto in which he proudly declared artists must turn away from idyllic pine trees and Homeric shores and embrace what Marinetti thought would be traits of the future—speed, machinery, industrialization.

I say sadly but I don’t feel sad about it, I don’t feel sad about it at all: futurism and futuristic speculations cause me chagrin. I feel perfectly overwhelmed trying to grasp what it’s like to be alive in the contemporary without pondering some remote, mercurial future where home nests excrete vapors that pacify colic-y infants and vogue gruels made of milky substance and pillaged rainforest fruits clean the colon and make the muscles of the abdomen walk out of fat like an Etch-A-Sketch.

In contemporary parlance, I submit, it’s little known the origins of Futurism rest in an artistic movement at all. Poor Marinetti! Now, rarely used in its noun form, it’s more shorthand for describing new-looking fashions—as in self-checkout is “futuristic”; toe-sandals are “futuristic”; IKEA furniture is “futuristic”; Black Mirror is “futuristic”; Apple Pay is “futuristic,” ad infinitum. It is employed, without understanding, to describe the habits, behaviors and characteristics of decades to come.

At times, I take great joy in misconstruing technologies for which I don’t immediately feel an affinity. For instance, at a pool party I might labor to depict a lizard piloting a drone to disparage the electric lawnmower. My jokes, in short, can be Luddite-themed.

I feel pessimistic toward dutifully working at grasping what will be, for a long time, a work-in-progress; I hold suspicion that the current form the technology takes will seem slow and misshapen in the future. Think, I advise myself, of dated cell phones—those crude outsized blocks, with microphones, alighting like craven mosquitoes on the ear. They are like cave dwellers to our common existence.

But of course this is all a bit tongue-in-cheek: I am, like everyone else, a beneficiary of technology and have spent the past few months writing about modernization and transformation in healthcare and how essential it is for medical providers. I disclose the feeling above in attempt to sympathize with people who resist technologies. In my own business, I eagerly lean into whatever promises to enhance the services I provide clients, however mind-numbing or obtuse getting a grasp on them might seem at the start.

Optimization in healthcare, using KPIs to improve care, trim costs, and gain efficiencies, employing modern tools, techniques and technologies, to optimize practices is not without work at the frontend and I feel that this initial effort is what often prevents providers from outfitting their practices with these analytics. And then we use the attitude described above to make justifications for outdated practices. But it is worth it, for both provider and patient, constantly to streamline office procedures.

Thus I am advocating that we lead a divided life, be savvy in our business and ostentatiously Luddite in our private lives. What’s the harm in this? Isolate the technocrat drinking Topo Chico at the pool party and disparage him behind his back with your likeminded friends. This is catharsis enough. But wake up Monday morning eager to learn the relevant technologies.

Get Behind Me, Cowbell!


I used to suffer a recurring anxiety dream that I want to share with you. The great writer Henry James once said, “Have a dream, lose a reader.” But please, bear with me. 

Imagine being atop a green hillside looking down upon a peaceful valley vivid in the fixtures of late spring (okay, I don’t dream in color, but go with it…) with magnificent pink heads of wildflowers growing out of the land and the trees of the mountains, the pines and aspens and birches, all comfortable in their renewed fullness.

And animals are everywhere here too, no doubt feeling even more acutely this transformation, this sloughing-off the barren skeleton of winter, with its crunchy ocean of snow, absent livestock, dormant trees locked in deadness. A fox scuttles across the glade.

Everything is lined in promise. Cows walk along the mild slope and get into the alpine lake and drink with their cartoonish tongues. At a distance they seem quite dapper, stately, even regal. I’ve never had much admiration for cows but in the dream I go straight to the heart of their impressiveness. When they walk out of the water, the sun pools on their wet haunches and brawny chests. They eat grass with contentment. Life seems quite profound, very resonant. I feel tapped in to deep feeling, the way some might perhaps when smoking an expensive cigar.

But because I am facing only one side of the hill there is of course an unlooked-upon expanse at my back, outside the immediate perception. It sneaks up on me and has that awful weight of anxiety like the he obsession of misplaced keys or the delusion of the front door being open in the middle of the night—that kind of restless irrational fixation that finds its home in something eerily particular.

Then a bell clangs. I turn around to discover a rogue cow audibly sucking a diabolically large grass blade, the bell on its fat neck tolling at the slightest tilt of the strange head. Behind it the landscape is, incredibly, in winter. It confronts me with this hostility I interpret as a wish to disturb the fondness I just felt at viewing the other side of the hill. It implies I am not entitled to that transformation.

I awake sweaty and perturbed.

I typically suffer this troubled nighttime experience during some kind of personal or professional tumult when I am choosing to leave an old conduct for a newer yet foreign one. The cow I see as representative of the world I am necessarily leaving but which is still in some odd way an element of the one I am pursuing. It wants me to remain in its obsolescence and the anxiety is spawned from the unknowns of the future. But I know I must transform as much as the seasons must change.

In healthcare, choosing the resplendent hillside means deserting the closed-loop systems and paper-heavy processes of the old world that may be convenient with respect to office operations, as transforming requires a bit of elbow grease, but do not represent what patients have come to expect from healthcare. A fully transformed experience for the patient means access to remote care, predictive analytics, patient portals and personalized care: this is the green hillside.

And patients have become terrifyingly informed about the incredible technology out there thanks to the all-seeing Internet. They know what they want and know how to say it and this should be a hefty motivation to compel every provider to tailor care to such informed desires.

It frightens you to have a cow appear at your back, signaling do not for forsake me, but we must slip out of the stranglehold of antiquated seasons for vital renewals or else play winter to someone else’s spring. 

Do not embrace the obsolete cow. Its bell tolls for a dead world.

Scan Here


Some people do not share in the thrill of new technologies. They overheat and pine for a world that has moved past them. They are called Luddites and spotting them in public is easier since the outbreak of Covid-19.

As restaurants began to reopen after that long and painful hiatus, they were required to adopt certain technologies to safeguard against increased risk of spreading the virus through dine-in eating. Along with wearing a mask while not seated at the table, there are contact-tracing protocols whereby your personal information is incorporated into a database that the restaurant can consult should a patron later succumb to the impartial disease.

And my favorite of all— the adoption of the electronic menu, using the camera on your smartphone to scan a QR code, which seamlessly directs you to a digital list of food and beverage offerings. This is when the Luddite is at the threshold of outburst.

Look for the person with mask drooping off one ear like a punitive earing and iPhone raised high in the air betraying confusion, longing for a list of appetizers but getting only an alien symbol, begging some moderately competent person to appear and shepherd them through the complexity of pointing the barrel of a smartphone at what is for all intents and purposes a kind of target sign marked “Scan Here.”

In terrible versions of this scenario a quarantined menu is drudged up from dusty retirement, re-sanitized and re-sanitized and re-sanitized and then begrudgingly delivered to the technophobe.

Do we resent such people? I fear so.

We resent them, I fear, because we have moved on. Modernization is there to fulfill consumer demands. During this insufferably long pandemic consumers yearned for the reopening of restaurants, a semblance of normalcy in a bewildering moment. And why wait five minutes for a hard-copy menu to come to your table when it can be readied instantly on your smartphone. The restaurants did their homework and zeroed-in on operational changes that would both accommodate our wish for them to reopen while making for the safest environment possible considering the trial at hand.

This is an example of what modernization can resolve. If we were a people comprised predominantly of Luddites, mitigating our strange new world would have been impossible because we would push back against technology, the very thing offering our deliverance. We perpetually would have been moored at home smearing a redundant condiment over our three hundredth turkey sandwich.

In one year, the entire medical establishment has seen how vital modernization is to patient care, and luckily, there was an infrastructure in place that provided the consumer with a metaphorical menu, if you will.

The problem presented was how to provide care which everyone goes on needing in spite of a pandemic— cancer doesn’t cede ground to a more popular disease—when the location of this care is deemed unsafe. Well, as with restaurants, the medical industry adapted, leaning heavily on modern technologies, the conveniences of digitization to fill in these gaps. Doctors began to refer to patient portals for requests for prescription refills, offered alternatives to in-office visits through Telehealth, relied heavily on longitudinal care and well-captured data to answer the kind of questions that otherwise might be answered during in-person visits.

It is my belief that what began as solutions to problems of the moment will become status quo in medical care.  Once the nation has reached an acceptable level of immunity, these changes will not be dispensed with. What parent wants to take their thirteen-year-old to an appointment every month for a refill of acne medication when it can be done electronically in the patient portal? Everything is moving in a technocentric direction, and providers must keep up with this change in the spirit of our time.

After all, it is better for the consumer. And whom else do we answer to?



One of the Internet’s gifts—and occasional annoyances!— is its space for people to self-publish their alleged expertise on a subject. Surely this must be some form of purging. I feel an odd mixture of depression and excitement toward these online message boards. The writers on healthcare forums vary from doctors, hospital executives, and private insurers, to young families whose finances have been wrecked by medical expenses.