Drs Allan Detsky and Alan Garber wrote an interesting piece in the New England Journal of Medicine this past week about innovation and disruption in healthcare. The authors point to the new “sharing” economy – specifically to the disruption in the transportation industry caused by Uber.
Detsky and Garber note “unreliable service, inconvenience, uncomfortable surroundings, and high prices” as reasons why Uber has found success at the taxi industry’s loss. The taxi industry had functioned as a highly regulated monopoly until Uber basically blew it apart. And while Uber hasn’t been successful in all jurisdictions, it has grown into a company valued at $62.5 billion that operates in 150 US cities and 58 countries.
But the authors believe that healthcare is less likely to be vulnerable to the same type of disruption. They note that a health care disrupter “confronts a web of regulations, contractual obligations, interlocking financial interests, and providers’ political influence” as reasons why there isn’t yet an “Uber of healthcare.” Detsky and Garber do a thorough job at pointing out past attempts at healthcare disruption and innovation – for example, medical tourism. They also mention retail clinics, although these clinics still only account for 2% of primary care visits.
The authors don’t discount that innovation is coming – far from it. But all the reasons they list are precisely why health care disruption both will and must occur. The flaws in the medical system and its unsustainable cost projections represent opportunities for more efficient, more effective, and cheaper alternatives to move in. And medical providers would be silly to ignore the warning signs. And we might learn a thing or two from those innovators.
As the authors mention,
Uber’s message for health care is clear. Providers have three choices: ignore innovators and hope for the best; call for increasing regulation to make it harder for innovators to enter the market; or compete on quality and efficiency, disruptive though it may be.