Disruptive leadership. That’s a thing now? I’m told that this is a kind of leadership—I thought it was a market dynamic.

Hmmm…

What does it take to be a “disruptive” leader?

Does it mean talk like a pirate when explaining how the company will be cutting benefits?

Does it mean dress like Ali G and try to imitate him but only muster a WASP accent?

I suppose it does…but that’s the easy part.

Job #1 in leading a true market disruptive: FIND AND FERTILIZE THE HIDDEN RAGE AT THE STATUS QUO THAT LIES WITHIN ALL OF US. Find it in yourself and feed it and then find it in others and attract them to work with you.

I’m constantly looking for change in my personal life. For example, I just bought a Tesla. My other car is a 1983 Land Rover. Why? Because in 1983 you didn’t need to sell cars with a seatbelt dinger and airbags in the front seat andD because Tesla is the first ATTACKER disruptive car maker to make it past the fetal stage in my entire life. I must feed them. I HATE the established car industry! I have been trapped inside a small number of culturally (and occasionally financially) bankrupt brands that have lost any interest in fighting the over-regulated morass that constraints.

In recruitment for athenahealth, we are looking for people with the same desire to change things for the better. Ever see this ad?

In retention, we blow up 30% of the jobs in the company every year and recycle the people into new roles. This way, if we accidentally hire a stability addict, we get rid of them within three years on average.

All of this is going well.

I think the biggest challenge I face as a disruptive leader is finding a way of leading this way without making my clients nervous.

Some 30% of our revenue comes from non-profit hospitals and 30% comes from traditional medical practices and clinics. These are some of the most conservatively run institutions in our society…and many of us like it that way. They are, after all, operating under the Hippocratic oath (“First, do no harm”). While they like that we know how to use the Internet, they DO NOT want to see anything fast and loose with who sees what, and I get it! They are also afraid of losing market share and deathly afraid of losing pricing power as society starts to come down on the cost of health care. My job is to serve these people and not scare or “disruptive” them.

Luckily, 40% of my revenues come from disrupters. These are venture-backed, for-profit businesses that have come to health care with disruptive business models. They include for-profit hospital chains like Vanguard, which has an expressly stated goal to REDUCE the hospitalization that it provides per capita by 25% and replace it with new market share and new approaches to care. They include an ambulance chain that is looking at providing emergency room care RIGHT THERE IN THE AMBULANCE, generating MASSIVE savings and improvements in quality of life for many chronically ill patients. They include MedExpress and other urgent care chains that set up shop outside overly busy ERs and treat the 80% of patients that don’t truly need a full hospital but do need treatment urgently in minutes! These guys are all growing like mad, which I love, but more importantly they are providing a model of DISRUPTION as a GOOD THING that the other 60% of my clients MUST learn from…or perish.

My goal is to keep my freak flag flying…but learn how to put it in my pocket and have a mature conversation with my established clients about why they want to become disrupters themselves. If I get them there, we are all good. If I don’t, I run the risk of being a risk or a disappointment to the majority of my revenue.

As athenahealth grows and the revenues from established, change-cautious players grows with it, the pressure to ease off will rise.

I must mature in my ability to keep doing it…but I must keep doing it…or I am afraid my clients will slip from part of the solution to part of the problem.

Jonathan Bush co-founded athenahealth, a leading provider of internet-based business services to physicians since 1997. Prior to joining athenahealth, he served as an EMT for the City of New Orleans, was trained as a medic in the U.S. Army, and worked as a management consultant with Booz Allen & Hamilton. He obtained a Bachelor of Arts in the College of Social Studies from Wesleyan University and an M.B.A. from Harvard Business School. This post first appeared at athenahealth’s blog.

Share on Twitter

11 Responses for “State of Disruption”

  1. spike says:

    “This way, if we accidentally hire a stability addict, we get rid of them within three years on average.”

    or more accurately

    “This way, if we find someone who hasn’t main-lined the Kool-Aid, we get rid of them within 3 years.”

  2. Great – I have been disrupting the change element drivers for the last three years. Their whole idea of “Forward” that is bound to the PPACA bill is nothing more than a rehash of Lenin’s 1921 ‘What is to be Done’. There is a long line of administrators, regulators, and government entities that I have rattled sabers with – and since most of them have not read the bill in it’s entirety ; it is mostly unarmed combat.
    It is not Tech that will drive the market – it is compliance. Ask Google Health… and most recently GlaxoSmithKline how compliance riddled their status quo models.
    You want to crash the system, and cut through the BS paperwork ? Disruptive practices are my specialty.
    Brian
    Health Care Hit-man

  3. I wonder if disruptive leaders when they have medical emergencies get treated in an ambulance at the curb side, before being hauled to a Vanguard hospital, or maybe just drive themselves in a Tesla to the nearest nurse-in-a-box, or do they go to a Harvard medical center, with hordes of famed specialists floating in and out….

  4. rbaer says:

    Could someone please summarize what was said in the OP? The casual style and use of caps made me DIZZY and I COULDN’T BEAR TO READ IT TO THE END.

  5. MG says:

    Vanguard is really a ‘disruptor?’ There financials compared against other publicly-traded hospital chains don’t really bare that claim out.

  6. Peter1 says:

    “I HATE the established car industry! I have been trapped inside a small number of culturally (and occasionally financially) bankrupt brands that have lost any interest in fighting the over-regulated morass that constraints.”

    Those “over” regulations have produced safer (see save lives), cleaner (see less polluting) vehicles – that is disrupting. Try getting smashed up against your 1883 Land Rover’s metal dash at 60 mph sans seat belt and air bag – to fully appreciate it’s nostalgia.

    “Some 30% of our revenue comes from non-profit hospitals”

    So much for the term, “non profit”.

    “Luckily, 40% of my revenues come from disrupters. These are venture-backed, for-profit businesses that have come to health care with disruptive business models. They include for-profit hospital chains like Vanguard, which has an expressly stated goal to REDUCE the hospitalization that it provides per capita by 25% and replace it with new market share and new approaches to care. They include an ambulance chain that is looking at providing emergency room care RIGHT THERE IN THE AMBULANCE, generating MASSIVE savings and improvements in quality of life for many chronically ill patients. They include MedExpress and other urgent care chains that set up shop outside overly busy ERs and treat the 80% of patients that don’t truly need a full hospital but do need treatment urgently in minutes! These guys are all growing like mad, which I love, but more importantly they are providing a model of DISRUPTION as a GOOD THING that the other 60% of my clients MUST learn from…or perish.”

    When can we expect U.S. prices and costs to be 50% of now and equal to the single-pay government run systems around the world – wouldn’t that be disruptive?

    Does “new market share” equal market domination and control so that insurers and patients won’t get the choice that so many “free enterprise’rs”
    claim is the panacea for our for profit driven system? Do your hospitals advertise to the community that they “do it for less”? How does this disruptive-ness benefit the long suffering individual and uninsured market?

    I’m not sure I could be around this guy’s ego for very long.

  7. Grace DeVierno-Lipson says:

    Mr. Bush,

    What can I do to persuade you nurses are vital to every health industry and indispensable to integrating new products? Really, what is more important medical billing or making sure there are enough nurses in the world to care for the sick. Also, a strong global nursing work force is critical for large health industries.

    For 14 of 15 years the CNN Gallup Poll have rated nurses the Number One most trusted profession in America (Sept 12- firemen were the deserved heros) .The iconic visual of nurses and business innovators inextricably bound, integrated, and indispensable to health solutions, will resonate with health consumer.

    Everyone is chasing doctors and overlooked the computers used by millions of nurses dispersed throughout the world at the patient’s bedside 24/7, clinic, or home. Why not pioneer or participate in an aggressive operating system that connects these nurses, but does not require new hardware or operating systems?

    The “The Nurse Portal” enables life sciences companies to efficiently survey this worldwide-connected community of nurses who self-identify by specialty and other relevant characteristics. Users will have the ability to access health knowledge, patient experiences, and professional knowledge anywhere in the world.

    The “nursing data” harnessed from medical records reflects information doctors and hospitals steer or ask the nurse to provide. Ironically, nursing expertise is aligned to give business a better understanding of the patient experience and products consumers’ want and trust.

    Clinical Trial Recruitment for any new drug (but especially for orphan and other hard to recruit for trials) is a function of the portal as industry can utilize the connected community of nurses to efficiently find clinical trial candidates for pharmaceutical companies and CROs. This feature is indispensible when difficult-life-death decisions need to be made rapidly.

    Health applications can be placed within our global platform, to inspire patients and families to share in their own health care.

    This Nurse Portal will lead to better human centric solutions, locate candidates for clinical trials, and be a solution to end the devastating nursing shortage.

    Grace DeVierno-Lipson M.ED. R.N.,
    Columbia University Email gralip@aol.com

Leave a Reply

FROM THE VAULT

The Power of Small Why Doctors Shouldn't Be Healers Big Data in Healthcare. Good or Evil? Depends on the Dollars. California's Proposition 46 Narrow Networking

Masthead

Matthew Holt
Founder & Publisher

John Irvine
Executive Editor

Jonathan Halvorson
Editor

Alex Epstein
Director of Digital Media

Munia Mitra, MD
Chief Medical Officer

Vikram Khanna
Editor-At-Large, Wellness

Joe Flower
Contributing Editor

Michael Millenson
Contributing Editor

We're looking for bloggers. Send us your posts.

If you've had a recent experience with the U.S. health care system, either for good or bad, that you want the world to know about, tell us.

Have a good health care story you think we should know about? Send story ideas and tips to editor@thehealthcareblog.com.

ADVERTISE

Want to reach an insider audience of healthcare insiders and industry observers? THCB reaches 500,000 movers and shakers. Find out about advertising options here.

Questions on reprints, permissions and syndication to ad_sales@thehealthcareblog.com.

THCB CLASSIFIEDS

Reach a super targeted healthcare audience with your text ad. Target physicians, health plan execs, health IT and other groups with your message.
ad_sales@thehealthcareblog.com

ADVERTISEMENT

Log in - Powered by WordPress.