The U.S. health care system is the world’s top in health care spending per capita, but in terms of performance, we’re dead last among developed countries. As a young physician embarking on a career in this landscape, it’s glaringly obvious that we need disruptive innovation to create better health at a lower cost. Physicians are uniquely positioned to make critical contributions to medical innovation, but even among my young colleagues, a minority of physicians perceive themselves as innovators.
Contrary to popular thinking, the creativity possessed by innovators isn’t a genetic gift. In twin studies, only 30 percent of creativity could be attributed to genetics. When it comes to innovation, nurture eats nature for breakfast. To build innovation skills, doctors can recognize three surprising advantages they have in the innovation game, and three skills to develop in order to make disruptive change.
3 innovation skills doctors have in the bag
Formal education and expertise. Aside from a few highly publicized cases of dropouts-turned-geniuses (like Bill Gates or Mark Zuckerberg), most innovators are well-trained in their field of enterprise. Without training, it’s hard to know the difference between what’s meaningful and meaningless, to separate the signal from the noise. Google’s cofounder Sergey Brin has graduate degrees in computer science. Peter Thiel, co-founder of PayPal, has two Stanford diplomas. In medicine, it’s not a coincidence that around 80 percent of all medical devices considered most useful were initially developed by physicians.
Above-average prudence. There’s a temptation to assume that all innovators are natural born risk-takers. Personality profiles of successful innovators, however, have revealed that they tend to be remarkably cautious. Great innovators are experts in mitigating risk and clearly defining acceptable loss. Doctors, similarly, are experts at estimating acceptable harm. Every diagnostic or therapeutic decision must weigh potential risks and benefits. And since our decisions directly impact human lives, doctors naturally lean toward risk-aversion, a trait that, according to author Paul B. Brown, makes for the “perfect” innovator or entrepreneur.
Healthy arrogance. Obviously, it’s never wise to oversell one’s ability, but confidence is a critical trait in successful innovation. Without Elon Musk’s well-known borderline arrogance, for example, his now wildly successful companies, Tesla and SpaceX, probably wouldn’t have survived brushes with near-bankruptcy. Innovators must be able to survive, persist, and recover from failure. If 20+ pre-med courses, one MCAT, four years of medical school, three steps of the USMLE, and three years minimum of grueling residency training doesn’t self-select for confident, persistent, and resilient people, I’m not sure what does.
3 innovation skills physicians need
Harness the Medici Effect. Innovative ideas flourish at the intersection of disciplines, and innovators intentionally position themselves at these crossroads in hopes of discovering new ideas from diverse experiences. Frans Johansson called the spark that happens when novel ideas from different experiences coalesce as the “Medici Effect,” a nod to the Medici family, whose patronage brought poets, philosophers, and scientists together. Ultimately, this gave rise to the Renaissance, a period marked by great innovation.
Physicians don’t seem to have caught on to the importance of cross-pollination. Around 40 percent of doctors marry other doctors or health care professionals. Most premed students still major in the life sciences. Ties with “industry” are frowned upon, and the idea of “networking” is met with variable favor. Instead of resource networking, which is focused on self-promotion, physicians should practice idea networking in order to discover new insights from people with diverse perspectives. Think of the group of people you would go to refine a new idea. How many are younger than twenty or older than eighty? How many are in a different profession, or socioeconomic group, or from another country? If the answer is “not many,” it may be time to expand the idea pool.
Be brilliantly lazy. Lazy is perhaps the worst four letter word to any aspiring or practicing physician. Hard work is so valued in medicine that we wear our hours worked and sleep sacrificed as badges of honor. But in innovation, easy and simple always trumps complicated and arduous. Bill Gates has famously stated he would always “choose a lazy person to do a hard job.” Why? “Because a lazy person will find an easy way to do it.” Who do you think invented the wheel? The guy who toiled away carrying a heavy load on his back, or the one who said “nope” – and found an easier way?
Question the status quo. Following the “if it ain’t broke, don’t fix it” mentality is great in caring for patients. We’re taught to largely leave healthy people alone, to avoid unnecessary testing and treatment. But this way of thinking can kill creativity, and only those who constantly question the industry standard create innovation. When Steve Jobs created the Apple II in 1977, he insisted that the device should be quiet. He questioned the need for a noisy cooling fan — which all computers had at the time — and asked, how can we make a computer run without a fan? Although most people thought the idea of a computer without a fan was ludicrous, he found one person — Rod Holt — who figured it out, and the rest was history.
In looking back on the last two weeks I spent on my hospitals’ medicine floor, there were many off-the-wall questions I could have asked. What if instead of admitting that patient with a heart failure exacerbation, we sent him home with a nurse to provide IV furosemide and check on him a few times a day? What if there was a non-invasive way to measure labs, instead of drawing tubes on tubes of blood every day?
Only the people who are crazy enough to think they can change the world are the ones who do. Let’s start by transforming our questions. As Jonas Salk, discoverer of the first polio vaccine, put it, you don’t invent the answers. You reveal the answers by finding the right questions.
Nicole Van Groningen is an internal medicine resident who blogs at AvantMed. She can be reached on Twitter @NVanGroningenMD.
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