Ok, you can now stop laughing. I know it’s an absurd idea that physicians could actually disrupt the current chain of healthcare investment into digital health, consolidation, direct to consumer care and the focus on convenience, right?
Is the opposite not equally laughable? What if I asked how healthcare investors could disrupt physicians and healthcare? Interestingly, that’s the statement most frequently made in healthcare. Would anyone object that healthcare investors are disrupting healthcare? Would any say the investors are doing a great job of making things better? Money driving disruption is making healthcare much better for all, right?
My take, healthcare is on the wrong path and everyone including patients, physicians, politicians and investors are paying the price. Healthcare costs and outcomes are worsening. As we push convenience, consumerism and invest in fragmented care healthcare is getting worse and investors are left scratching their heads.
I recently listened to a very interesting podcast which really opened my eyes to the fact that the walls between investors and physicians must come down. I would encourage you to listen to this excellent dialogue by some very intelligent and well-intended investors. The heart of healthcare podcast is a great listen. My apologies that I don’t know the podcast well nor why its called the heart of healthcare but I will investigate further. I also don’t know the speakers and my intent is in no way to pass judgement. I was really enlighted by the conversation and the perspectives. Perspectives that are so very different from mine as a practicing physician, serial innovator in healthcare and most recently as a digital health founder. A founder who tried to gain investment in real solutions and more complex challenges only to be rebuffed by investors looking for quick wins and easy workarounds to the problems.
The podcast did reinforce my belief that we have lost the physician voice when it comes to how to “fix” healthcare. I appreciated the candor of the participants and the mistakes made in “Covid” investing. Having been in the midst of the chaos myself, the mistakes were pretty obvious to me throughout the pandemic. I witnessed the mistakes of where the investments were going and how very few were actually “fixing” anything. Revenue was all anyone really was interested in, not margins or outcomes or longevity.
As a physician, it was refreshing that these investors discuss the future with an eye to a triple aim. A triple aim of the right investment not only driving revenue, but lowering costs and driving better outcomes. This lesson was lost in COVID as investors ran in headfirst to a world without a physician’s perspective. .
My experience the last 7 years in digital health are best represented by the image included. Healthcare is a bucket and investors are trying to plug one hole or looking for a quick fix to complex problems. They seek to plug one hole in the bucket, while failing to see the other 20 holes. They also do not recognize that putting a finger in one hole may create two more. I find that many who don’t practice medicine struggle to see the ripples of their actions on other aspects of care. I get this image of “Dear Liza” and smile at the approach of the problem solving via Sesame Street. We all want a quick fix and feel that our stick in the hole is the answer. What do I think we are missing in digital health, technology and healthcare innovation?
I think most fail to truly understand how complex healthcare is and how so much is more art than science. Algorithms and data are fantastic, but worthless if we can’t change patient behavior for the better. I wish more investors understood that the key to solving the complexity of healthcare must center around relationships. Relationships are the key driver of our healthcare “system” and the more holes we put in the bucket or fix with a “stick” the less likely we are for our bucket to hold any water. We will need to continually add water and get little in return for our efforts. For physicians, desperately trying to fix the holes, we are running out of sticks and energy.
So here is how I believe that physicians can disrupt healthcare investing… there is a hole in the bucket and this is how we can fix it….or at least improve …
1. Physicians need to lean into the innovation and investment community. Physicians have become too isolated and distant from healthcare innovation and problem solving. Our fear of these investors leads to a “them vs us” mentality that is hurting the efficiency and effectiveness of where the dollars are invested. For investors, they should seek input of physicians open to discussing and ideating around solutions. We need more physicians willing to have these conversations. Physician silence, distance and/or finger pointing is not helping anyone. Investors need our perspective. We need to foster relationships with the innovators and the investors.
2. Physicians need to lead the purchase and adoption of solutions to our problems. Our addiction to the cheapest workaround leads to the development of more workarounds and not solutions. We are our own worst enemy if we are not investing in physician led companies and solutions instead of workarounds. If we leave innovation to others let’s not be surprised that our lives and our patients lives become worse. I am often perplexed when physicians complain about their patients going elsewhere for lesser care that is “cheaper”… yet, we physicians tend to not look more deeply into how we decide on what we invest in within our own practices. Physicians and investors need to add due diligence in our investments to ensure we are driving solutions.
3. We must change the narrative on what “patients” want and what physicians want. In my estimation, the joy in medicine from both parties come from the relationships we have with each other. The shared decision making and behavior changes needed for better health need to center around relationships. Investors need to understand that innovation that supports relationships is how we fix healthcare. Physicians, nurses, patients, specialists, pharmacy can’t run in siloes and expect better outcomes. If investment can “disrupt” healthcare than why can’t it be a connector as well? For physicians, we must recognize that change doesn’t stop. The world is changing rapidly and holding on to what “used to be” is not working. Hope is not a business strategy is how I think the saying goes. We are being passed over and worked around the more we try to stand still.
4. Physicians must re-examine where our future lies? If you want to predict the future than we must build it. Investors think buying doctors or “consumerism”. will help fix healthcare. Frustrated doctors think selling to investors will fix their problems. Personally, I haven’t seen either path fix healthcare for the better. Investors need to take a hard look at whether consolidation is driving better care and I am still looking for better outcomes in this push for the “consumer” replacing patients. Physicians need to ask if selling is driving better care. If not, then why do we all continue down this path? Wouldn’t investors and physicians be wise to more closely align? Are there different ways to align dollars to drive better care not just more? Should physicians embrace fellow physician innovators and physicians who want to help lead investment in solutions?
There is a hole in the healthcare bucket. The holes are growing and more holes are cracking open all the time. Big buckets are not fixing the holes. To fix healthcare we don’t need sticks or quick fixes, we really need to recognize that we can only fix the bucket with relationships, collaboration and changing our mindsets toward all involved in healthcare. We need more of everyone’s expertise and more understanding of what outcomes can look like when we drive innovation that truly works. We need to start fixing them so our system can hold water. Physicians, why can’t we disrupt the future of healthcare investment?
Note: As a reminder this newsletter is written from my experience and perspective. The newsletter does not imply or relay the opinions of others. The intent is to offer an avenue for dialogue and discussion around important topics in healthcare and healthcare innovation from one doctor’s perspective. I am a physician and so can only write from my perspective. If you are clinician, provider, nurse or whatever my goal is to enable you to agree or disagree and have not intention to suggest or imply that only the physician perspectives matter. They do matter but as part of a larger dialogue that can foster better health outcomes.
