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Disruption, by its very definition in Webster’s Dictionary, is to interrupt
or suspend normal activities – i.e. to create a different experience for the
intended customer that is better than what currently exists. Medical
organizations that harness the art of disruption create greater wealth and
success by changing how things are done. Simply by changing the
perception and perspective of what is common is enough to create economic
and growth opportunity.
At the heart of positive disruption is innovation. Innovation takes
many forms, from the scientific and technological breakthroughs to changing
the way patients interact with the doctor’s office. It is the willingness to see
new ways of doing things without changing core competencies – the lifeblood
of medicine.
For example, much to the chagrin of many providers, retail clinics are
rising and growing at rapid rates. What makes retail clinics appealing to
patients today is the same thing that made urgent care centers appealing
twenty-five years ago – ease of access, convenience, and rapid response.
We can argue the merits of why they are good or bad but the fact remains
that they meet a strong consumer need providers do not address even if the
reasons why are legitimate. Recognizing the value of patients’ time and
lifestyle demand, as it relates to waiting to see a doctor, is just as important
as the value of the doctor’s expertise.
To argue that physician assistants and nurse practitioners cannot
replace a doctor is true but we use them as physician extenders for routine
matters and we encouraged these very same patients to accept this premise
ten years earlier. Did we not then help set the stage for retail clinics to occur once larger groups of patients found it difficult to comply with more
traditional ways to access their doctors?
Retail clinics represent an example of changing the way things are
done in order to address the realities of medical access by disrupting what is
considered common routine. The point is to recognize that what has always
worked, in the past, may become obsolete as the needs of society changes.
In this case, society’s need to value the demands placed upon patient time is
greater than it was twenty years ago. For many, waiting is simply no longer
an option any more than many medical offices are willing to wait for patients
who become excessively late getting to their office because of traffic. The
reality is that more and more traditional medical offices are seeing patients
during normal, established, and traditional business hours rather than
considering the possibility of aligning their goals with patient lifestyle
requirements.
Is it that we are against retail clinics because they are legitimately
clinically inferior, or is it that we don’t like the competition it creates among
traditionalists? Disruptive innovation is uncomfortable because it creates
competition among the healthcare community, forcing the strategic
reevaluation of how things get done. Fair competition creates an
environment that requires us to step up our game to benefit the very people
we strive to serve. Disruptive innovation forces us to reexamine our
assumptions and beliefs on what we think medical excellence is versus what
our patients value.
Another example of disruptive innovation is a grass roots movement to
change the way in which we choose to treat patients. Instead of treating
patients based upon the way providers are reimbursed, their medical
specialty, and response to acute episodes, there is a growing focus on
prevention, results, outcomes, and cycles of care. It doesn’t change the core
expertise of doctors, but does profoundly change the emphasis of how care is delivered. The emphasis on results forces providers to compete for patients
based on demonstrated outcomes, not personal brands, as is commonly done
now. It also challenges us to consider that, if we are to drive down costs and
increase value, the medical industry should compete like every other
industry.
The provider that focuses on African-American rhinoplasties as his core
competency makes more money than the doctor who offers a multitude of
plastic surgery services. The provider that focuses on women’s incontinence
makes more money, and works fewer hours, than her counter-part that
provides OB/GYN services. Why? Because they become exceptionally good
at what they do. Their success rate increases over time, their costs drop,
and their efficiency rates increase. The cost to perform services stabilizes or
drops. They can compete on outcomes and results not on their specialty.
The same concept is applied to disease states such as MS, Diabetes,
Cardiac, TBI, and other traumatic and chronic diseases. It is not the fact
that an endocrinologist can serve diabetes better than an internist, it is the
fact that a team of people are assembled to treat the specific disease over a
life time of care that is important. Encouraging a collaboration of expertise
brings value to patients and optimizes patient health over the long term.
Disruptive innovation, by its very nature, is not mainstream, but it
does have evidence to support that it works. It turns long held beliefs on its
ear and demands consideration by providing evidence of its success. In the
case of treating specific disease states over a cycle of care, evidence is
provided by measuring outcomes, detailed data collection, and the
willingness of physicians to have their treatment protocols standardized and
measured for continuous improvements. Mainstream medicine resists
measurement, but their disruptive counterparts are quietly gaining respect
around the country. More importantly, they are not working harder, but
smarter, and earning more without passing costs onto their patients, the
insurance carrier, or shifting costs elsewhere to be absorbed.
Disruptive innovation does not suggest that we take the latest
technology or medical breakthrough and market it as a means of
differentiating ourselves from one another. Not if the emphasis is on
charging more money while realizing incremental value in comparison to an
older treatment method.
Instead, disruptive innovation is about using technology and medical
research to change outcomes and results in profound and meaningful ways
that enhances the patient’s quality of life. At one time, the pharmaceutical
and medical device industry practiced disruptive innovation the way it was
intended. Seven different ways to treat a cholesterol problem is no longer
considered innovative and only encourages diminishing returns on the
investment. New and improved medical equipment and devices may
incrementally increase outcomes, but at what cost and worth? Would the
money have been better spent if it had been focused on innovative
technology that breaks new medical ground?
The medical community, in an effort to stretch growth, often looks to
what is mainstream as a means of generating new sources of income. A
good example is the use of medical spas. It is a great idea, with short-term
growth capabilities for the majority of medical providers. Disruptive
innovation looks to break through mainstream ideals by introducing what is
uncommon. It is not for the faint-of-heart and requires business acumen and
strategic thinking as a prerequisite.
By nature and by training, the provider community is risk-adverse,
causing many to duplicate business models or not question mainstream
methodology. It traps medical providers into false security for a period of
time. But, like any other business in any other industry, what they do
becomes obsolete and their ability to earn income deteriorates if they don’t
keep an eye toward the future. It takes moxie to be disruptive and to learn
the art of disruptive innovation in a way that benefits patients and providers
by bringing value and success to both, not one over the other.
The central keys to successful disruptive innovation are: To know your
patients, not just from a treatment standpoint, but also from a lifestyle point
of view; To recognize what business you are in and how you contribute to
the betterment of society by your distinction strategically; To be innovative
in what you do in a way that is valued by the people you serve and aligns
with your core principles and competencies; To have a culture that
encourages innovation as a core principle of your business; To reach for
excellence and raise the expectation of what excellence is among all that
work with you; To use technology as a tool that encourages value and
innovation; And most importantly, to have the moxie to be different in a way
that shifts the paradigm of what is, so that the contribution improves society.
Disruptive innovation marries the art of medicine and the art of
business, and by its very nature, is both revolutionary, yet quiet, and accepts
change as an everyday occurrence. It demands strategic planning, research,
and business acumen at its core to succeed. Those that lead the way and
are willing to risk it appropriately are rewarded handsomely.
Author
Ms Horowitz is CEO of M2Power, Inc. a strategic management firm specializing in health care
and small business. She is also a licensee of the Maestro Business Academy providing
education, counseling, and tools for owners of small business and health enterprises. You may
reach Ms. Horowitz at 516 409-0849 or by email at info@m2powerinc.com for more
information or to provide comments. Find out what the medical industry is doing to medical
providers by requesting her article "The Death of Dr. CEO".
Editing provided by Kenneth Lopez a practice administrator in Longview, WA. He may be
contacted at Radman47@aol.com
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