Telluride, Nepal and Looking Deeper…….

As I was born and raised in Nepal, I felt like I will not have problem being in this altitude. But I soon realized I was so wrong, I was out of breath after few steps uphill. I also began to appreciate how well maintained Telluride the town is. If places in my country were managed or organized this way, we could probably do so much better with tourism industry and move our country in right direction. But what I wish, what general people wish and expect are not fulfilled because we do not have good leaders at the top, we do not have resources, and the influence of surrounding countries do not make it easier either. When I look at health care industry here in the States, I feel like it is the same way: patients want everything to go perfect, and healthcare providers wants the same end results as that of patients, but to get there, do they have enough resources and support from the system where they are working and also influence from other institutions and policy makers? The answer right now is No!

Nepal, as a country was not so bad few decades ago, but when a leader makes a mistake and there is no repercussion, they do another mistake because they know they can go by with it. Gradually the mistakes make their way down the chain and everybody or at least majority of them are infected by it. I used the word infection because it is spreading like a plague in the system. It is same in the healthcare system, it was better before and but with few mistakes that were overlooked made the system worse gradually. When whole system is affected that way, a new person/leader/healthcare provider even though wants to make a change; he/she will have very hard time crossing that barrier that has been created in the system. He/she will probably change themselves to fit in the system eventually and end up being not happy with what they are doing.

I am glad we are doing something here at Telluride to break that system. I believe in General System Theory and ripple effect. We have to make an effort to change the system before we start blaming anyone. The more we talk about it and more we do something about it, more ripples it is going to produce and the change is possible. However, we have to understand that to change something that is new and hasn’t had much influenced on people is easy, but when we have to break a culture of a system, then it becomes a very difficult and daunting task. But I believe as a small mistake gradually led to system failure or broken system, a small effort to change the system positively can gradually repair the system.

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