Commentology: The Creative Destruction of Healthcare

THCB reader and occasional contributor Dave Chase had this to say about Bill Crounse, MD’s recent post “Why the Creative Destruction of Healthcare May Not Be a Good Idea.

“There is no doubt there are some obnoxious people throwing around arrogant/naive ideas. However, the “creative destruction” and “disruptive innovation” that has been most impactful has come from physician-entrepreneurs. Often, they are the most provocative and hard-hitting in their language.

It seems loosely similar to how the most virulent anti-smokers are former smokers. They want others who they can relate to experience the liberation they’ve experienced.

I wouldn’t assume ill-intent from these MD-entrepreneurs using direct language. They simply were fed up with what they experienced as “broken” and stepped up with approaches that have out-performed.

I’m thinking about the MD-entrepreneurs and innovators who have led CareMore, Nuka Model of Care, Qliance, Iora Health, MedLion, Healthcare Partners, etc. Sometimes to catalyze change, one must use stark, hard-hitting language.

That doesn’t seem like a foreign concept to the many excellent MDs I’ve known over the years. I have enormous respect for any entrepreneur, especially one coming from tradition-bound professions who are willing to stick their neck out and endure enormous personal financial risk.

Bob Margolis shared how his colleagues referred to him as a “communist” and his team-based model as “communism” yet Bob’s org achieved far better outcomes. He had the last laugh when that “communist” sold his business for $4.4B last year.

The comments from these MD-entrepreneurs is they feel they aren’t doing their MD friends any favors by candy-coating what is widely recognized as a system that isn’t close to reaching its full potential.

In contrast, the orgs those MD-entrepreneurs are running are the reigning “Triple Aim Champs” that we should celebrate — colorful language or not. Often the most impactful entrepreneurs aren’t particularly “polite” in their language — Steve Jobs, Bill Gates, Larry Ellison et al called it like they saw it.

What’s wrong with that?”

3 replies »

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  2. There is a long history of intellectuals questioning the value of medical care and the scientific model of medicine. This goes back to Foucault. Nothing new here, but maybe we could examine last the inflammatory obfuscation for some kernels of truth.

    Health care is about providing reassurance, “gee-whiz” treatments, generating profits and perhaps impacting public health.

    Something’s obviously out of whack, but certainly not the profit-generating capacity of the industry. I suspect most people are looking at the public health impact of health care delivery and finding it wanting. Perhaps it is a customer-centric deficiency.

    Like so many human endeavors, it seems to me we could benefit from refining the definition of what exactly we want to disrupt.

  3. Well put. A good example of this is Al Lewis skewering the wellness industry. Apparently they will not listen when someone calmly tells them their numbers are made up, and savings do not exist. So he uses withering humor. Seems to have affected the entire sick care complex.