Saving Lives by Stripping the Power of Doctors | Big Think

Saving Lives by Stripping the Power of Doctors

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Business strategist Clayton Christensen argues that nurse practitioners and retail health outlets should have increased authority in treating patients.

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Clayton M. Christensen:

Clayton M. Christensen is a professor of business administration at the Harvard Business School. He is the bestselling author of five books, including his seminal work, The Innovator's Dilemma, which received the Global Business Book Award for the best business book of the year, and most recently, The Innovator's Prescription, which examines how to fix our healthcare system. Christensen serves on several public and privately traded boards and is the founder of a successful consulting company and an investment management firm. He holds a B.A. with highest honors in economics from Brigham Young University and an M.Phil. in applied econometrics and the economics of less-developed countries from Oxford University, where he studied as a Rhodes Scholar; he received an MBA with high distinction from the Harvard Business School in 1979, graduating as a George F. Baker Scholar, and was awarded his DBA from the Harvard Business School in 1992.

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TRANSCRIPT:

Topic: Bringing Disruptive Innovation to Healthcare

Christensen: A good way to visualize how disruptive innovations transform an industry is if you think of the geography of an industry as a set of concentric circles.

I’m Clayton Christensen, the Robert and Jane Cizik Professor of Business Administration at the Harvard Business School.

Question: How can disruptive innovation transform healthcare?

Christensen: The advent of sophisticated healthcare technology in the form of surgical suites and advanced imaging equipment and these big high speed multi-channel blood testing and analytical equipment has driven a centralization of the healthcare industry, so we have to take the patients to the hospital rather than to bring the solution to the problem. Now, do you think hospitals will ever become cheap by competing against each other? No. They’ll actually become more expensive. So what we need to do is drive the disruptive decentralization of the healthcare industry and we do that by bringing technology to outpatient clinics, so you can begin doing there the simplest of the things that within the past required a hospital and then keep driving that technology so that they can do more and more and more sophisticated things in that setting. And then we bring technology to doctor’s offices so they can begin doing the simplest of the things that previously had to be referred to a more expensive clinic and then drive that technology so that you can do in the doctors' office more and more the things that were required at the higher cost clinic. And then use technology to drive care to the home. And in a similar way, do you think healthcare will become cost effective if we just expect doctors to take pay cuts? That will never happen but instead we need to bring technology to physicians assistants and nurse practitioners so that they can begin doing the simplest of things that previously required a doctor and then drive that technology so that they can do more and more of those things. In other words, it’s by enabling lower cost venues of care and lower cost caregivers to become more and more capable of doing more remarkable things. That’s the mechanism by which healthcare becomes affordable not by expecting the expensive ones to become cheap.

Question: What specific innovations are most vital to the future of healthcare?

Christensen: Personal electronic medical records are very important to the future of healthcare. The challenge that we have to confront is care has to be coordinated and the reason why care has to be coordinated is there are interactions amongst drugs which if one provider prescribes a patient to take one set of drugs and another provider prescribes a different set for different disorders, those two things might interact in the patient’s body in really adverse ways and create real problems. One provider needs to know what other providers have previously done, so that we know whether or not a patient responded to a therapy so that we don’t duplicate tests and so on. Electronic medical records are really very important to assure that the right care is delivered to the right people without duplication or contradiction. In the past, a doctor could provide all of that coordination.

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