Joshua Liu, MD
Co-founder & CEO at SeamlessMD
LinkedIn: Joshua Liu
X: @joshuapliu
Co-host: The Digital Patient Podcast
Musings and Insights
Health Tech entrepreneurs sometimes blame their lack of success on healthcare’s “unwillingness to innovate” despite “claiming to want to innovate”.
I sympathize with their frustration, however I don’t think the blame is fair.
No one is happy with the status quo in healthcare. Most people in healthcare wish the incentives to innovate and improve patient care were stronger.
Yet we can’t forget that most stakeholders are acting rationally given the “rules of the healthcare system”, whether we like it or not.
In most other businesses you either sell a product that helps a company improve revenue or decrease cost – either directly or indirectly.
Healthcare is unique because there’s a 3rd dimension we “care” about: patient outcomes.
So unsurprisingly some entrepreneurs and innovators focus on this 3rd dimension. And we assume (hope?) it will be valued almost as much as the other dimensions.
At first this seems reasonable, given that healthcare training teaches us that doing what’s best for patients is right. So it never crosses our mind that maximizing patient health would need to be justified.
And then we graduate into the “real world” where we learn how the business of healthcare interacts with actual healthcare delivery.
We learn that healthcare organizations run into conflicts when we add this 3rd dimension.
Lots of things that improve patient outcomes don’t lower costs (or at least not immediately), and in fact, may increase them. And behaviours that improve outcomes almost never increase revenue for the stakeholder acting on them.
Many hospitals still make more revenue if a patient gets readmitted shortly after being discharged. Surgeons still mostly get paid to do more procedures and not to ensure past procedures went as well as possible. Patients require multiple appointments because “one problem per visit” gets paid for.
In turn this means that Health Tech solutions that improve outcomes remain lower priority (and less compelling) than solutions that drive revenue and throughput. Few will say it to your face (because it feels awful and weird to admit it) however it’s reality.
Ultimately healthcare, like any system, has a financial model that underlies it. And that model is managed by rational actors.
For me what helps is mentally putting myself in the shoes of health system leaders and frontline staff. Start from the assumption of good intent, and work backwards to understand why they would or wouldn’t be motivated to adopt your innovation.
More often than not, you realize most reasonable people would take their stance. Sucks to realize it, but the truth will set you free in many ways.
That doesn’t mean you should give up.
But it does mean that you need to find some balance between idealism and pragmatism to find success in Health Tech and Innovation.
Blaming doesn’t help. Understanding does.
Health Tech entrepreneurs sometimes blame their lack of success on healthcare’s “unwillingness to innovate” despite “claiming to want to innovate”.
I sympathize with their frustration, however I don’t think the blame is fair.
No one is happy with the status quo in healthcare.… pic.twitter.com/Uoqv4Gq3s1
— Joshua Liu (@joshuapliu) February 18, 2024
The Digital Patient
The Digital Patient takes an “edu-taining” approach to all things digital patient care. On this show hosts Dr. Joshua Liu, and Alan Sardana talk with healthcare, technology, and innovation leaders about the latest advancements in digital health, trends in digital transformation, and strategies for optimizing the patient experience.