Disruptive innovation creates wealth in medicine

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.

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