The human condition loves metaphor, a manner of voicing something in the moment to rationalize the assertion of knowledge and leadership. Truth be told, metaphors can underlie a deeper issue: A blind ignorance to understanding change. And no other industry reflects this like the pharmaceutical sector.
Yes, there’s blame to go around. No one is innocent, especially since regulatory oversight plays a huge role in catalyzing this reality. But it’s the devil we’ve got. With all the well-intentioned benefits to transparency and accountability it brought forth, the sad truth is: It fostered an age of risk aversion, anti-collaboration, anti-innovation and cold, often actuarial-style decision-making where the economic bottom line ultimately defines the scope of measured impact for the improvement of patient wellbeing. Bad stuff.
This may have been tolerable before the Internet’s “Golden Age,” but nowadays, regulatory is one of the biggest barriers to moving forward in a meaningful way. I don’t suggest we re-open the floodgates that initially put us into this situation, but perhaps it’s time to audit the true impact of these restrictions.
Mind you, regulatory is but one half of the conversation. Act II for this theater of the absurd lies in the confluence of three specific social change factors, all converging within the past five years to create the most significant disruption in healthcare since the invention of Viagra.
1. The Chronic Patient
Advances in medicine, technology, risk management, lifestyle choices, public awareness, etc., transform the “acute death sentence” of most diseases to that of a “chronic condition” that you learn to manage. It’s no longer about quantity, but quality. This shift creates a new category of healthcare consumer with unique and largely underserved needs due to the absence of the supportive infrastructure the system is unaware it needs and is currently unprepared to handle.
2. The Internet and ePatients
Combine massive, national consumer disenfranchisement with the myriad Internet social platforms and, for the first time, you have a powerful, influential and stentorian consumer-driven narrative demanding the change they wish to see. One unifying message emerges: They deserve better and demand equity. Once again, the system is disrupted and grossly unprepared to meet the needs of the very clients it’s meant to serve.
3. The Next Generation
Young adults are largely unknown in the war on cancer (72,000 diagnoses each year and 800,000 U.S. survivors, aged 15 to 39), but as “The Sandwich Generation,” over 80 million young adult Americans will—or currently do—serve as caregivers and influencers to both their younger children and older parents and grandparents.
What’s most relevant: This most under-recognized and underserved age group in healthcare is also the most influential. Gen X and Millennials are the driving force of change. More so, they do not engage with the system like their predecessors. Pen and paper? Physical mail? What’s a stamp? Artifacts of a time long gone—and again, the system is disrupted and remains ill equipped to meet—or even recognize—the needs of its key stakeholders.
Considering these three major factors, how has the healthcare industry responded in kind? It has not, with minimal exception. Few are taking the leap of faith necessary to close the gap between the march of progress and the stagnation of regulation. And social media’s amplification of citizen dissatisfaction across generations unifies a demand for change where there is no supply from the healthcare industry.
Enter the Private Sector
The new startup bubble of acronyms like EMR, DHR, HIT and countless more otherwise known as “Digital Health.” Hundreds, nay, thousands of brilliant young minds kneeling at the altar of the one killer platform to rule us all. Since Google’s and Microsoft’s health initiatives failed, I ask if it’s even possible. After a good six years, I can count small success stories on one hand. The challenge I see: The system is just so broken, territorial, fractioned-off, profit-driven and risk-averse that the idea of progress seems as distant as Betelgeuse.
The Health 2.0 Movement
Largely led by Millennials, yes, those people who might otherwise be cast asunder as slacktivists, this sandwich generation that the industry doesn’t understand is actually the man behind the curtain. They control the strings of innovation and social media. They will benefit most from the change that needs to happen.
Millennials are patients, too. And, “patient” doesn’t always mean “the person who is sick.” The word is now a euphemism for an “angry healthcare consumer demanding equity.” They’re the ones deriding the inanity of a cancer center’s lack of age-appropriate survivor care planning, or the utter ridiculousness of the cost of medicine and how 62% of all bankruptcy is medical bankruptcy (and that over two-thirds of these people actually have insurance).
The Health 2.0 sector has yet to mobilize a national patient community to foster meaningful systemic change. Additionally, patients—specifically cancer patients—are risk averse to adopting digital health platforms that are profit based. No one really wants someone bankrolling their sob story when all they need is help.
It’s 2014 and collaboration is the new competition. Pharma is so limited in its capacity to be innovative that there seems to be a moral imperative to force an unheard of thought—it’s time to engage the nonprofit sector, specifically patient advocacy organizations (PAOs).
Typically risk averse, slow to change and facing serious barriers to success, many charities are adding an entrepreneurial (B2B) component to their strategic operations. Indeed “survival of the fittest” also applies in the charity world, which is why, of the 1.3M U.S. nonprofits, more than half fail in the first three years. In fact, 94% of them generate under $1 million in revenue per year and a staggering 45% bring in less than $25,000 per year (source: Charity Navigator). The handful of baby turtles that do make it to the ocean have no choice but to adapt to changing times.
Gone are the black tie galas, Vodka luges, races for cures or trying to prove to a grantor that you’re valuable and worthy of charity. High-profile brands, savvy marketing skills and charismatic leaders just don’t cut it anymore. Running charity like a business is the new black. Innovation, disruption and critical thinking are what is taking place—and catching everyone off guard. The establishment doesn’t understand how to respond to a market sector that is fostering progress that it doesn’t understand the value of and/or is ill equipped to engage with due to stalwart and flaccid business philosophies.
Nonprofits Are Underused
Trustworthy PAOs with national recognition, a solid reputation and a penchant for disruption may seem like the outliers to avoid, when in fact their influence shapes progress, and the loyal community of millions they bring to the table are an invaluable resource not to be ignored.
It’s time to get with the times and find solutions where you least expect them. Nonprofits are your underutilized business partners. Public-private healthcare partnerships are transforming social issues online and on the ground. B2B relationships with charity are often unheard of but that is changing because it has to. The future of healthcare technology will be patient driven. Industry will then have the choice to lead, follow or get out of the way. Don’t be afraid to look where you least expect.
It truly is the patient, stupid.