You Can’t “Elon Musk” Healthcare

Yale School of Medicine


On January 26th, Philadelphia discovered that the 22-year-old organizer of its largest COVID-19 vaccination site, Andrei Doroshin, had turned away elderly members of the Philadelphia community from their vaccine appointments. Instead, he pocketed extra vaccine vials to administer to 4 friends and girlfriend. An RN witnessed the event and reported it to authorities. 

Local news reporters quickly discovered that this incident was just the tip of the iceberg for Doroshin. A Drexel University graduate student with no experience in healthcare, Doroshin had enlisted his college friends to organize a group that would go on to win one of the biggest vaccination contracts from the city of Philadelphia. He told his friends that “this is a wholly Elon Musk, shoot-for-the-heaven type of thing,” and that “we’re going to be millionaires.” His organization had also amended its privacy policy allowing for patient data to be sold, administered large numbers of vaccines to people ineligible to receive the vaccine yet, and threw Philadelphia’s COVID vaccination program into chaos

For the people in the back: One can’t simply “Elon Musk” healthcare. We have seen this too many times – a privileged young upstart with little experience believes that s/he can transform healthcare and make millions – or billions – doing so. Examples abound: we only have to look a couple years into the past to remember Elizabeth Holmes, the Stanford dropout who founded Theranos and misrepresented its technology, or to Outcome Health, whose former CEO Rishi Shah defrauded investors by overinflating business metrics. If “move fast and break things” works in other sectors, many reason, why won’t it work in the 4 trillion dollar industry of healthcare? 

Healthcare is simply not the kind of business where one can shoot a rocket into the sky and accept the risk that it might explode. Simply put, this is people’s lives we’re dealing with. But a deeper layer involves trust in the medical establishment. U.S. healthcare is already marred by multiple grave issues: a complex bureaucracy, serious health inequities, and astronomical costs that can bankrupt a person in just one hospitalization. The trust that people have in U.S. healthcare has steadily dropped over the years. Further, the politicization of the COVID-19 pandemic and the U.S. government’s bungled response to it has only sowed further distrust, especially among marginalized and minoritized communities

Each healthcare fraud or scandal only creates more distrust in the communities who need healthcare the most. And who would blame them? Andrei Doroshin turned away elderly 85-year-olds “standing there in tears,” and Elizabeth Holmes’ technology misread blood potassium levels so poorly that the “patient would have had to be dead for it to be correct.” These deceptions demonstrate that modern American healthcare is still very few steps away from the Tuskegee Syphilis Experiment, the forced sterilization of women, or say, an utter failure to respond to a pandemic.

American healthcare doesn’t need more “disruptors.” It needs more helpers. It needs more leaders with conscience. This does not mean that entrants from the tech sector aren’t welcome – rather, these entrants have a lot to share regarding fresh ways of thinking and creative uses to technology. The blend of technologists and clinicians can produce amazing and clinically rigorous new products. But new technologies and practices can’t simply be refined by “experimenting” on innocent patients. The scientific method, institutional review boards and ethics committees exist in healthcare for a reason. 

 With all due respect to Elon Musk, the idea that a “genius” can enter healthcare and single handedly transform the industry must end. Too often these people overpromise what their privilege can provide and leave vulnerable patients with the mess. Entrants into healthcare need to understand that health tech is much more about “health” and much less about “tech” – and that in healthcare, people must always prevail over profits.

Sofia Noori, MD MPH is the Chief Resident of Digital Psychiatry and the Chief Resident of Quality Improvement at Yale Department of Psychiatry.