Who is health care’s Steve Jobs?

by Hans on 2010/04/05

With all of the hype surrounding the release of Apple’s iPad, I came across an interesting post on CNN titled “the iPad and the failings of the computer industry“. It’s an interesting view on an apparent lack of visionary, inspirational leadership in the computer industry. The author wonders why no other computer company, let along another leader, can “pick-up a discredited idea and created not just a successful product, but a whole new industry”. He also goes on to wonder if Apple can continue its string of successes if/when Steve Jobs retires. Who will succeed him?

While the success of the iPad is still to be determined, the article had me thinking about the situation in health care. Health care is in many ways similar to the technology industry. There are large powerful forces at play in terms of regulation, behemoth organizations, and competition from multiple different players. Why is it there isn’t a single (or handful) of innovative, inspirational leaders that can be health care’s “Steve Jobs”? We sure know that health care needs help. If crippling costs don’t destroy health care, then the burdens of bureaucracy will.

In my undergraduate days, I was often told that Canada was once considered an innovator in terms of health care. Some of the major accomplishments included:

  • Development of publicly funded health care options: Tommy Douglas is often cited as the father of Canada’s health care system.
  • Recognition of the social determinants of health: The Lalonde Report (formal title “A new perspective on the health of Canadians”)
  • Support for the healthy cities and wellness movement: Being Canadian, our professors focused on Ottawa’s participation in the healthy cities alliance.
  • Banning of smoking in public places: This was originally considered ground-breaking, but then Canada was chastised for back-tracking on this.

Nevertheless, I had been given the notion that Canada was at the forefront of innovation in health care. Today, I’m not so sure. I think the recession in the 1990s and recent poll-driven governments have focused not on innovation and inspiration but rather on controlling costs and getting (re)elected. Now, I don’t get the sense that people look to Canada for leadership. New Zealand, Australia, the UK, and the US are the first places to look.

It’s sad when we look to a faceless, behemoth organization like Kaiser Permanente for leadership. Don’t get me wrong – I think Kaiser is an amazing organization that is doing some excellent work. It’s just that I don’t see an HMO being inspirational. In the opening pages of The Innovator’s Prescription: A disruptive solution for health care by Christensen, Hwang, and Grossman, the authors quote a passage from the Bible “Where there is no vision, the people perish” [Proverbs 29:18] which I think is on point. Where is the inspiration in health care? Some of my friends who are physicians tell me stories about how they enter medical school with dreams of healing people and making a difference, but have those dreams squeezed out. In fact, they say that only the rare individual can survive medical school’s training programs and not feel special and entitled.

I’ve done some work with high-school students and I’ve kept this saying in the back of my mind. It echoes the passage from Proverbs.

If we can’t inspire and capture the imagination of the youth, we have failed

I think it’s time to focus more on what is possible and to inspire those in health care rather than simply looking for the cheaper and easiest solution. Maybe we just need to find health care’s version of Steve Jobs to help push the transformation effort along. Perhaps President Obama has taken that first step by engaging in health care reform and getting people involved in the issues. [side note: Pres. Obama needs to be recognized for his work on health care reform. I don’t agree with the final legislation but he did the impossible and has shifted an entire industry. I hope he can continue in his efforts.]

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