Imperfectly Seizing the Unknown: Embracing Innovation in the Medical Profession
Kevin Kelly, former editor of Wired magazine, wrote an article several years ago where he discussed the radical transformation of the global economy based on the digital revolution of the 90s. In the article entitled, “New Rules for the New Economy”, he postulated several “rules” to help individuals and companies thrive, not merely survive, under these new conditions.
Without doubt the entire article is fascinating, yet one quote sticks out over all the others. Mr. Kelly proposed, “Wealth in this new regime flows directly from innovation, not optimization; that is, wealth is not gained from perfecting the known, but by imperfectly seizing the unknown.” Profound, right?
Much like the digital environment that Mr. Kelly was writing about, there has been an equally radical shift in the business environment of private practicing physicians as well – one every bit as jarring and transformational. It stands to reason that parallels can be drawn between the two events.
Innovation NOT Optimization.
If innovation is the new guiding principle, what is meant by optimization? The manager’s credo for years has been to take what exists and to make it better, be it personnel, products, or processes. Efficiency became the buzzword as the profitability equation (profit = revenue – expenses) was vexed by an ever-decreasing revenue coefficient and matching rising expenses.
Classes abound at regional and national tradeshows describing maximizing patient throughput (remember the wave scheduling craze?), adding billable revenue sources (add PT, add MRI, add mid-level providers), increasing existing services (add ultrasonic guidance to injections), etc. Perhaps these changes added revenue to the bottom line for a season, or perhaps the changes were instituted just ahead of changes in regulation or reimbursement remodeling leaving practices on the backside of the trend, never seeing the promised pot of gold at the end of the proverbial rainbow.
In short, the many solutions to the problem were little more than placing a Band-Aid on a gaping wound – the paradigm has changed. Something more is required to escape the cycle.
Innovation, in its truest since, is disruptive, uncomfortable, and often radical. It is an expansion into the known world in a way that seems like the discovery of a new world altogether. Innovation is not about the business of incremental advances in known systems but the implementation of systems unknown.
Think Christopher Columbus, Henry Ford, Thomas Edison, Steve Jobs – these radical innovators never left terra firma, but they took what was known and brought us into the great unknown.
Innovation in Orthopaedic Management
It has been said that the working definition of insanity is doing the same the over and over yet expecting different results. Isn’t it possible that optimizing our existing failing system is tantamount to insanity? So, what does innovation look like in orthopaedics?
Without a doubt it will include – strike that – it must be fueled by technology. Yes, all of the systems you fear, the technologies your friends tell horror stories about, the computers your physicians yell about, the web portal your patients scream about – these are the tools of innovation.
But hasn’t innovation always come through pain?
“The horseless carriage is loud, stinky, and less dependable than my trusted horse!”
“There is no way that we are going to invest in the electric light bulb when the gas lamp lit our city streets for decades”
“New passage to the east by going west? Insanity! Blasphemy!”
Yes, technology is the driver for profitability and success in every industry in the U.S. and it will be for private practicing orthopaedics as well. The question that remains is: Will you be found as one who embraces innovation and becomes a local innovator in your own practice, or will you be one of the naysayers who become a byline in the annals of history?
The world has switched from black and white to color and you have landed in a strange new land. Will you continue to try to “optimize” existing systems, slowly losing ground to your competition? Or, will you take on the task of the innovator and “imperfectly seize the unknown”?