How Steve Jobs mentored a physician and changed health care

How Steve Jobs mentored a physician and changed health careI’ve been reading A Game Plan for Life: The Power of Mentoring written by famed UCLA basketball coach John Wooden.  Wooden spends half of his book thanking the people who had a powerful influence on his life, coaching, philosophy, and outlook on life.  Important people included his father, coaches, President Abraham Lincoln, and Mother Theresa.

Yes, President Abraham Lincoln and Mother Theresa.

Though clearly he could have never met the former and didn’t have the opportunity to meet the latter, Wooden correctly points out that as individuals we can be mentored by the writings, words, and thoughts of people we have never and will likely never meet.

Which seems like the most opportune time to thank one of my mentors, founder and former CEO of Apple, Steve Jobs.

Now, I have never met nor will I ever meet Steve Jobs.  Lest you think I’m a devoted Apple fan, I never bought anything from Apple until the spring of 2010.  Their products though beautifully designed were always too expensive.  I’m just a little too frugal.  I know technology well enough that people mistaken me for actually knowing what to do when a computer freezes or crashes.  Yet, the value proposition was never compelling enough until the release of the first generation iPad.  Then the iPhone 4.  Finally the Macbook Air last Christmas.

No, thanking Steve Jobs isn’t about the amazing magical products that have changed my life as well as millions of others.  It’s more than that.  What he has mentored me on is vision, perspective, persistence, and leadership.  Nowhere is this more important than the world I operate in, the world of medicine.  Increasingly health care is fragmented, confusing, and frustrating for patients.  As Dr. Atul Gawande noted in his commencement to Harvard Medical School:

Everyone has just a piece of patient care. We’re all specialists now—even primary-care doctors. A structure that prioritizes the independence of all those specialists will have enormous difficulty achieving great care.

We don’t have to look far for evidence. Two million patients pick up infections in American hospitals, most because someone didn’t follow basic antiseptic precautions. Forty per cent of coronary-disease patients and sixty per cent of asthma patients receive incomplete or inappropriate care. And half of major surgical complications are avoidable with existing knowledge. It’s like no one’s in charge—because no one is. The public’s experience is that we have amazing clinicians and technologies but little consistent sense that they come together to provide an actual system of care, from start to finish, for people.

We don’t have an actual system of care.  A majority of doctors still use paper charts and prescription pads which can be difficult to access or decipher (doctors have poor penmanship?) and communicate with colleagues via letters, faxes, and phone calls.  In an industry which is information driven, this seems too antiquated to be true.  Hospitals each have their own unique system of care and their is little standardization which means both patients and doctors need to learn new rules with each new hospital.  Patients cannot invest in long term relationships with their doctors because they change jobs, their company or their doctors dropped their previous insurance plan.

What we have is a potpourri of doctors, hospitals, pharmacies, and health insurers cobbled together to form a “health care system”.  For a patient, the number of combinations is staggering.  Each experience varies depending on who they see, what insurance coverage they have, and the type of (or lack of) information technology their doctors have.  Many doctors today still bristle at the possibility that they actually need to email their patients and as a result don’t offer that as a way of communication or education.

In the end, what patients and doctors really want sits at the intersection of humanity and technology.  Patients want doctors who know them as individuals, use medical technology thoughtfully, and a system that is highly reliable, safe, and focused on them to stay well or get them better.  Doctors want patients who are partners in their care, technology that enables them to get the accurate information they need real-time, and a system that is streamlined to allow doctors to be healers.

In other words, we need a better health care system for both parties.

As a practicing primary care doctor, his words inspire me to help work towards creating a system which “simply works” for both doctors and patients.  Some of the most important quotes that has shaped my thinking include:

“Innovation has nothing to do with how many R&D dollars you have. When Apple came up with the Mac, IBM was spending at least 100 times more on R&D. It’s not about money. It’s about the people you have, how you’re led, and how much you get it.”
— Fortune, Nov. 9, 1998

“It’s really hard to design products by focus groups. A lot of times, people don’t know what they want until you show it to them.”
— BusinessWeek, May 25 1998

“It comes from saying no to 1,000 things to make sure we don’t get on the wrong track or try to do too much.”
— BusinessWeek Online, Oct. 12, 2004

“Do you want to spend the rest of your life selling sugared water or do you want a chance to change the world?”
— The line he used to lure John Sculley as Apple’s CEO, according to Odyssey: Pepsi to Apple, by John Sculley and John Byrne

“So you can’t go out and ask people, you know, what the next big [thing.] There’s a great quote by Henry Ford, right? He said, ‘If I’d have asked my customers what they wanted, they would have told me “A faster horse.” ‘ ” – CNN / Money

“My job is to not be easy on people. My job is to make them better. My job is to pull things together from different parts of the company and clear the ways and get the resources for the key projects. And to take these great people we have and to push them and make them even better, coming up with more aggressive visions of how it could be.” – CNN / Money

“Your time is limited, so don’t waste it living someone else’s life. Don’t be trapped by dogma — which is living with the results of other people’s thinking. Don’t let the noise of others’ opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.” – Stanford 2005 commencement address

Many of my blog posts have reflected on whether health care can indeed be better than it currently exists much the same way Jobs has redefined how we as a society communicate, relate, receive, and create content.

Does America Want Apple or Android for Health Care? 

What Steve Jobs and iPhone 4 Antennagate can Teach Doctors and Patients

Why Healthcare Needs to be More Like Apple and Less Like Windows / Intel 

I as a doctor I’m incredibly sorry that medicine has not yet evolved to the point that a cure exists for the rare type of cancer Jobs.  I’m sorry that he is so ill at an incredibly young age, in his mid 50s, when many people begin to contribute even more to society with all of the knowledge and experience they’ve acquired.  The future might be a little less bright without Jobs leading his team at Apple on creating products and experiences none of us truly knew existed until he showed them to us.

And yet, I wanted to thank him for his mentoring.  Clearly though the outpouring of comments and support across the web, Steve Jobs has had a profound influence in many of our lives.  In most cases, it wasn’t even about the products.

It was simply a way of living and viewing life.

I look forward to learning one last time from my mentor this fall with the release of his book titled Steve Jobs. 

My thoughts are with him, his family, and the people at Apple who continue to innovate and challenge themselves so the rest of us benefit.

Davis Liu is a family physician who blogs at Saving Money and Surviving the Healthcare Crisis and is the author of The Thrifty Patient – Vital Insider Tips for Saving Money and Staying Healthy and Stay Healthy, Live Longer, Spend Wisely.

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  • http://pulse.yahoo.com/_3CY2U67646G7UIAHBQVTT2UP4Y Kristy S

    This is a very well-written article.  When I saw the news alert last night that Steve Jobs had died I was like “oh my goodness”, and then said out loud “oh no”.  My mom asked me what was wrong and then I told her.  I can’t believe that Steve Jobs is gone.  I was just a kid when computers were starting to be used in classrooms of schools, and to watch how they along with newer technological advances like the Ipad have been truly something to see.  Times have really changed in the 40 years that I have been alive.

  • http://www.facebook.com/people/Craig-Koniver/100001463176810 Craig Koniver

    Great article and many fantastic points. I whole-heartedly agree that Medicine is in the dark ages when it comes to using technology to connect with patients. We are certainly moving towards a better place directly because of Steve Jobs–the iPad and iPhone make these digital connections so much more appealing. Thanks again.

  • http://twitter.com/roacruzmd Raymond Oliver Cruz

    Yes, we may need inspiration from Steve Jobs to make health care more responsive to the needs of the public.  His ability to relate to what the people want and need are things that physicians must emulate.  Great article!

  • http://www.facebook.com/people/MJ-Radosevich/1472048989 M.J. Radosevich

    Wonderful reflections and tribute regarding the gifts Steve Jobs shared with the world.  Thank you Dr. Lui

  • http://www.facebook.com/people/MJ-Radosevich/1472048989 M.J. Radosevich

    Wonderful reflection and tribute by Dr. Lui to the gifts steve Jobs shared with the world in his creativity.

  • http://pulse.yahoo.com/_FOPAG46FCYE3BKQ7GCW57Y7D7U Elena

    Very empathic, intelligent reflection on how a person like Steve Jobs could help Dr. Lui
    reflect on the value of “people” in healthcare as opposed to technology alone.

  • http://www.facebook.com/profile.php?id=1529576072 Celia Palmer

    I agree with the comments below and so add my thanks to you for this article.  I love the well chosen quotes.  I am a primary care physician in New Zealand and what struck me though on reading it was how different the health system is over here.  We can send referrals automatically to hospitals that send back acknowledgements. Discharged summaries are sent electronically.  We can look up peoples test results that they have had (ordered by any physician).  For one local hospital we can look up the hospital record.  We use texting regularly to remind people to come to their appointments and let them know changes about their care.  We use the internet constantly as a source of reference.  (Thanks Steve.)
    There are still practices and the majority who have long term relationships with their patients.  At the moment though it feels like we are choosing to move away from this.  Policy makers want big primary care centres and specialists in them.  The system they want sounds more like yours.  More expensive and less humane.

  • http://pulse.yahoo.com/_TKA4WBQLQYEC2IPAKJQ3MRLNRY nayyar

    A very intelligent and interesting comments . Althogh in India this concept still conceptualizing . I am really impressed by Steve who led a life battling with cancer but still contributing to the society. This inspires us also to do the same in our life .

  • Anonymous

    Very good tribute a real genius of our times.It is not just the technology he created but the philosophy of the man so beautifully captured in the quotes mentioned.
    Medicine has been the slowest to adopt to technology and no wonder it is still so fragmented. In spite of such great advances made in the medical science, sadly the challenge Health systems the world over are facing  is delivery of this care. We definitely need a system which works for patients and doctors. If only we can think out of box… like Steve did.
    Dr.G.V.J.Prabhakar

  • Anonymous

    Very good tribute to a real genius of our times.It is not just the technology he created but the philosophy of the man so beautifully captured in the quotes mentioned.
    Medicine has been the slowest to adopt to technology and no wonder it is still so fragmented. In spite of such great advances made in the medical science, sadly the challenge Health systems the world over are facing  is delivery of this care. We definitely need a system which works for patients and doctors. If only we can think out of box… like Steve did.
    Dr.G.V.J.Prabhakar

  • http://pulse.yahoo.com/_KURBZDJZN2PJ7VVYVYPBUV5JRU Robert Hincken

    BRAVO!   Thanks Doc for the wonderful insight etc……

  • http://twitter.com/drmavromatis Juliet Mavromatis

    Thanks for your thought provoking blog Dr. Liu.  I like Steve Jobs too.  Reading your blog caused me to reflect on what it is that I like, because I don’t really know much about him. He seemed like an authentic, unpretentious and nice guy who was passionate, determined, highly successful, and very private. The material result of his work was innovative products, a well respected brand, and a lucrative business.  Interestingly to think about how that might translate to health care delivery, given that market forces don’t operate normally in our realm–though certainly the personal qualities that he embodied are admirable. I look forward to reading more about him.

  • http://www.facebook.com/people/Jackie-Swenson/100000046998781 Jackie Swenson

    Both Steve Jobs and Bill Gates are college drop-outs.  They would have lost their creativity if they stayed in school receiving the ‘formal’ education.  There’s no way for a person to become a competent physician without rigid medical training.  This kind of article needs to become a constant reminder for our care-providers to ‘think outside the box’ and think from the patient’s (consumer’s) point of view.

    • Anonymous

      AWFUL

      Kevin, frankly, this was awful. “Mentor” implies *direct* contact with a teacher. Writer did *not* directly learn from Mr. Jobs.

      Highly questionable thinking, IMHO.

  • Paul Kaiser

    If nothing else, it’s healthy to just “reflect”. Nice article. It was a way of living that Steve provided.
    I dont know where you find time to practice health and have such a great blog :)

  • http://twitter.com/andawna Andrew Lohbihler

    Its ironic that Steve can “help” healthcare, when he couldn’t adequately help himself. I think that many people are trying to build up his legacy, especially when his book reports that he stole everyone else’s technology and passed it off as Apple’s expensive products. He was too stupid and stubborn to understand the gravity of cancer and seek the best care possible. That should be a good lesson to us all, think different, think smart and get educated. And, yes, I do like Android.