Wow! Another app which helps you buy the latest in fashion. How cool and innovative! And yes, we must solve the dating problem first. It’s such a huge market opportunity. We must also get people to buy more cars, used cars, furniture and used furniture, pet food and used pet... (uh oh sorry!)
What about healthcare services and helping healthcare professionals reach more people and deliver better quality care?
Well, you know doctors are very difficult to deal with, they are tech laggards, the sector has too many regulations, too little money to be made and I forgot what else.
Before I get castigated for appearing to blame the techies from doing anything but scratching on the surface and not putting my own ilk on the dock, let me do precisely that. Doctors go through seven-12 years (yawn!) of education to become highly specialized. But what the high degree of specialization does is that it kills any creativity and out of the box thinking skills. Those who have just about survived five to six years of medical school to know enough about the space but still left with their logic and sanity intact would be the right guys to think of start ups in healthcare services… but then, who wants to be a generalist these days. I was once asked by a guest at home, about my specialization. I didn’t want to confuse her with public health administration, so I said, “Well I am a general practitioner.” Instantly her eyes screwed tight and she said, “Oh only a generalist.”What she meant was, “Oh I am so sorry, is there no body part that you were good enough to specialize in.”
I was recently reading about the IIT drop out who heads a leading tech-enabled consumer start-up who shoots emails and his mouth off and I was thinking would any VC touch a medical school dropout with a telescopic thermometer (if there is a thing such as that), if he came to them with a good healthcare services idea which would take a few years to show traction- because its healthcare right, everything has to be touch and feel and word of mouth!
The other issue that makes healthcare different is that you aren’t sure of whose problems you are trying to solve… or which problems.
Cute apps which schedule and reschedule appointments, free up doctors time slots, let patients choose when they would like to see which doctor are all trying to solve problems of both patients (I don’t want to wait for long) and doctors (I want to fill all my slots). However, in a city like Bengaluru, for every doctor who is seeing at least 10 patients a day there are at least twoor threedoctors who are spending their time playing Candy Crush Saga or Solitaire, while waiting for patients. Is it because, they are not qualified or incompetent? No, it’s simply because the paying public would like to go to the ‘best& the busiest’ only, even if it were for cough, cold, fever routines. If it were not for the irrational“this doctor’s’ medicines work wonders”, we wouldn’t have this problem in the first place.
Healthcare is also a domain, where the problems are, neither clearly perceived by the consumer today (when it comes to healthcare, the consumer isn’t always aware of what his her problem is or what is best for him/her) nor necessarily are solutions to the same sought by doctors(doctors will not like solutions which reduce their patient load or revenues). A classic example would be providing proactive preventive care for Type 2 diabetes, using technology tools. No diabetic is really aware of all the serious complications that await him/her if they do not keep their blood sugar levels under control at all times. When they do not see any signs or symptoms on a daily basis, they do not perceive the risk of say being on dialysis in 15 years time or having a foot ulcer in 20. Doctors would like their patients to have reduced risk of all of this, but if the solution proposes that a lesser trained nurse can monitor progress and suggest solutions to the patient, which potentially may reduce the direct income to a doctor, doctors would be skeptical of the benefits.
Therefore, the key challenge faced by would-be disruptive entrepreneurs is to understand the ways in which healthcare remains fundamentally different. Success in healthcare requires a nuanced understanding of the problems to be solved, since these problems are often not perceptible. It also requires the entrepreneurs to work closely with doctors and other medical professionals. This is tough if you choose to work on a problem in a specialty area such as cardiology or oncology. Specialist doctors are busy people, saving lives and will not have time for fireside chats. They are also obsessed with their knowledge and skills and cannot perceive of a world beyond, or that someone else can solve their problems. Once the problem is well understood, the solution needs to be thought through using various prisms- the patient, the provider, the intermediary hospital or nursing home, insurance, the pharmacy shop, friends and relatives, the regulatory bodies and anyone else living under the sun! One thing to note here is that doctors are also paranoid about losing their business and clientele and they view anyone with a solution suspiciously or worse don’t take them seriously!
So getting back to where I started from, why would the tech entrepreneur want to work on healthcare? Where are the doctors who want to create enterprises that stand out as healthcare problem solvers and value creators? We need entrepreneurs who are made of a different metal or better still, from a different planet.
The problems exist, the solutions aren’t as easy to find…. Let’s go get them boys (or girls)!
(image credits - shutterstock.com)
About the author:
Dr Anand Lakshman is the Founder & CEO of AddressHealth, a Bengaluru-based company which is trying to make continuity of basic healthcare possible for children.