Are we coming upon the end of institutionalized social services?
By “institutionalized”, I mean large, anonymous, process-based systems that serve a mass quantity of people, poorly – rather than a small quantity of people, well. We see institutionalized social services in health care, education, and government.
This is not an issue of government intervention or free marketism – at least not directly. Instead, it appears to be a coalescence of personal care, personal education, and technological enabling.
Consider Hugh Dubberly’s recent article in interactions magazine, where he notes a similar trend: “Reframing health as self-management parallels similar trends in education, where we increasingly recognize students manage (or design) their own learning, and design practice, where we increasingly recognize users manage (or design) their own experiences. Perhaps these changes are part of larger trends, the democratizing of professionalism and the shift from a mechanical-object ethos to an organic-systems ethos.” This trend helps to explain the recent fascination with design in the context of big business (or perhaps the fascination helps to explain the trend); the designerly way of considering problems is organic, not linear, and certainly not driven towards algorithmic repeatability.
In some ways, the institutional services that may be rapidly failing us – health care, education, and government – mirror the commodity object markets that have emerged in consumer electronics and car manufacturing. And the reasons may be the same, but made much more acute by the personal interactions necessary in a service: “users” are more different than the same, can not be easily segmented or chunked or profiled, and can – with the aid of education and technology – provide the same service offered by the institution, but _in a much better fashion_.
That’s not to say that doctors, teachers, and politicians have no purpose in this utopic post-institutional service infrastructure (although one might argue the last point). In the same way that designers build experience frameworks for people, so too will these professionals begin to control more of the experiential and behavioral qualities of their services. In many ways, this begins to feel like the true democratization of design, and the designers themselves can begin to support other professionals in humanizing the technology associated with their professions.
And so the doctor no longer “treats the patient” by addressing the discrete symptoms that make up a discrete problem. Instead, he works together to build a lifestyle health plan that’s unique for the individual. Why are you getting a cold every other week? What types of food do you eat? Let’s observe your exercise routine. Perhaps the doctor will spend a day with a patient, observing his life and proposing changes both nuanced and large.
The teacher no longer “teaches the student” by delivering content to be “learned”. Instead, they work with students individually to build an educational plan that’s unique for the individual. You learn best visually, by making things? Great – let’s apply that in everything from science to physical education. Most interested in things relating to guns and weapons? Fine – we’ll use that as a backdrop to describe math and physics.
Sounds silly – like some social pipe dream? It might be, but it’s starting to happen all around us. Nutrition coaches go shopping with clients, watching how they shop and then helping them correct their behavior. Schools like The Big Picture offer the one on one learning (and in many cases, one student with three teachers) described above. Clearly, the deinstitutionalized services require a dramatic shift in the number of hours spent between professional and “user”. But that’s a part of the larger trend Hugh describes above – the shift towards a organic-systems view of the world, where efficiency and number of customers served are simply irrelevant metrics to track human services.