I find many of the discussions with friends and colleagues about re-imagining healthcare experiences of the future shackled by the present. And hence, innovation ends up being incremental. Always, about how to make a better hospital, use some more technology to improve current processes or find a way to industrialise diagnostics and treatments. In order to truly imagine the future and how we’d like our children to consume healthcare, it is important to step away from legacy systems or behaviours.
There’s so much that’s not right with healthcare. Patients are not happy, doctors are not happy, governments are not happy and payors, paying more and more each year, are certainly not happy. Sometimes, it feels macabre to be working in an industry that feeds off the morbidity and mortality of the masses. On the other hand, can there be anything more gratifying than spending your life improving health for people around the world? I prefer to hold the latter view.
With some apprehension, a few of us convened a meeting of small group of people passionate about the future of healthcare. The invitees represented a diverse range of beliefs and backgrounds. The agenda was to be an unconference, not have a real structure nor agenda and just let the conversation flow, powered by the energy of the participants. The pre-requisite – leave your organisational imperatives at the door. We weren’t interested in and did not want the discussion to be biased towards product plug-ins from our work lives. The promise we made – a great cup of tea or coffee and some great conversation.
Healthcare issues that most impassion us
We met three times over last 9 months in Mumbai, called ourselves the Healthinkers (thinking health, thinking healing or health tinkering) and had a riveting 4 hour long conversation over the 3 meetings. Our group ranged in age from the 2nd to the 6th decade. The Healthinkers’ backgrounds spanned public health, medicine, surgery, policy, entrepreneurship, consulting, patient safety, investment banking, advertising and pharmaceuticals. Here’s some of the themes we touched upon (in no order of priority).
Doctors starting off on the wrong foot
The high degree of fragmentation in the medical community and investment to acquiring a medical degree means young doctors start off on the wrong foot in their careers. There was quite some lament about the fact that many medical students get into the profession on the singular premise of making money. The lack of well-aligned incentives institutionalise unsavory practices that dilute the trust bond with the patient community.
Mis-aligned incentives to serve patient needs
We spoke a lot about the mis-aligned incentives in the healthcare system. There are no incentives for keeping patients healthy nor for minimising interventions for the heavily invested private hospitals, diagnostic and imaging facilities. Population health that provides medium-long term returns has no known revenue models and is underinvested in by the government.
Focus on low cost should not replace health outcome conversations
In India, there is an excessive focus on access and affordability, especially “low cost” solutions. The third pillar of outcomes doesn’t get spoken about all that much. We also spoke about the difficulty in defining outcomes since they may be perceived differently by the patient, the doctor, the hospital and the policy makers. Pushing conversations on health outcomes will be critical to judge the quality, extent and the impact of healthcare investments made and to argue for experimenting with innovative delivery models.
Eroding trust in the healthcare system
We spoke a lot about the eroding trust in doctors within society. This was a particularly emotional topic for many of the physicians in the group. The notion of a doctor compromised by the easy lure of money is a timeless one, written about in the 1937 AJ Cronin novel, the Citadel as well as in the 1971 Indian movie, Tere Mere Sapne. The chatter on eroding trust has always existed, but seems to be getting louder today. This trend doesn’t bode well for healthcare as a profession. We need to be able to entrust our health to doctors who not only represent the best and the brightest, but also hold our trust and confidence.
Can the healthcare consumer expect a warranty on services provided?
One of our Healthinkers runs a chain of primary healthcare clinics in low-income communities and offers “warranties” on certain treatments. Sundeep understands all the cons of such warranties but believes treating health seekers like consumers puts the right pressure on his system to optimise processes, deliver better care and take accountability for outcomes. We don’t know if this idea will work in the long term. Nevertheless, its ideas like this that emerge from unshackled conversations like the one we had.
I personally left these conversations energised, optimistic and bursting with hope. The people in the room were assuming accountability for changing things. All the talk was about what “we” should do to improve things, very little blame cast on regulators, policy makers or “others”. That is inspiring. The Healthinkers meeting reminded me that if we are to create a more trusted, healthcare ecosystem, we need to create space for leaders of diverse disciplines to chart that path.
We will continue to expand the Healthinkers community with passionate leaders from various disciplines. Our hope is to provide a platform for leaders to learn from and challenge each other. If we could steal a spark from the fire these leaders carry in their bellies, perhaps, we could truly disrupt the healthcare experience for our children.
You can join and shape the Healthinkers’ conversations on Twitter.
Healthinkers so far: Aakash Ganju, Aditi Hazra-Ganju, Sundeep Kapila, Amit Malik, Sohan Shah, Adheet Gogate, Raman Madhok, Nayanabhiram Kalnad, Saleha Antulay, Sonali Vaid, Tanvi Joshi, Tanay Surkund, Neel Fofaria, Aastha Jain, Neeraj Apte, Puneet Goenka, Vainateya Gavai, Rajan Madhok, Abhijeet Kumar.
Dr Aakash Ganju is a healthcare consultant and entrepreneur, focused on increasing transparency, access, and convenience to health providers and consumers. He is the CEO of Mirai Health and lives in Mumbai, India.
A version of this article was published on Tincture.