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.