You've Been Planning All Wrong

Like many of you, I spend a lot of time thinking about the future, especially the future of healthcare.  There are so many things to consider.  Changing demographics.  New technologies.  New findings about, or approaches to, health problems.  New entrants and new combinations of existing competitors.  Changes loom everywhere.

Jeff Bezos thinks about the future differently.  When it comes to business strategy, he said:

It's interesting, I do get asked quite frequently what's going to change in the next 10 years. One thing I rarely get asked is probably even more important — and I encourage you to think about this — is the question: What's not going to change in the next 10 years.  

Wow.  Mind blown.  Of course that makes sense.  Of course it helps explain Amazon's relentless strategy that, for many years, ignored profits for long-term investments.  Of course it should apply to healthcare as well.

Mr. Bezos elaborated:

The answer to that question can allow you to organize your activities. You can work on those things with the confidence to know that all the energy you put into them today is still going to be paying you dividends 10 years from now.  

Otherwise, he warned, companies constantly have to change their strategy trying to cope with things that change.  He believes that thinking about the things that won't change doesn't require extensive research: "As soon as you think about it that way, these things are so big, so fundamental; you can just write the answers down."

In Amazon's case, it's all about lower prices, fast shipping, and a large selection.  As he explained: "It's impossible to imagine people saying to me, 'Jeff, I love Amazon. I just wish you delivered a little more slowly. Or, I love Amazon, I just wish your prices were a little higher."

He offered some other tidbits that are worth noting:

• "You have to be a missionary, not a mercenary. And, paradoxically, the missionaries end up making more money."
• "If you have a business idea with no risk, it’s probably already being done."
• "We need big failures in order to move the needle. If we don’t, we’re not swinging enough."
• "People who are right a lot listen a lot, and they change their mind a lot."

Not much of that sounds like what's happening in healthcare, does it? 

Healthcare people have a lot on their minds these days.  The future looks like a scary place, or certainly a very different one.  There are lots of people evaluating what's coming, and how it will impact them and their healthcare organization.  Consultants are being hired, projections are being made, reports are being written, plans are being formulated.

Millennials and successor generations are not going to be as patient as prior generations, and will be much more tech-savvy.  White males are not going to be the standard.  "Traditional" families are already not the norm, and the family structure and support systems they used to bring will be different.

Our system is already so expensive that traditional funding sources can't keep up, and it seems like things are only going to get more expensive. Things like artificial intelligence and Big Data are clearly going to be part of the future, but exactly how they will fit it, and what existing approaches and personnel are going to be impacted, are unclear.  Genetic engineering/editing, nanobots, and 3D printing will change the approaches and cost structures our healthcare system has been used to.

Lions and tigers and bears, oh, my!

When it comes to thinking about the things that won't change in healthcare, I worry that too many people think they boil down to:

• there will always be patients;
• they'll pay whatever they have to in order to have even a chance to get better;
• better health requires more health care.

Luke Skywalker would know what to say about that:

Too often, our healthcare system sees itself as the thing for which patients must change.  And that most definitely is going to change.

Thinking about the things that don't change is harder than Mr. Bezos suggests, at least for me.  Nonetheless, here's my list:

• Patients are, first and foremost, people, with lives that matter to them;
• Health care is only a small part of what brings health;
• People want to be healthy, although they're not always sure how to achieve that, nor always willing to make the effort they should;
• When they aren't feeling right, people want to be comforted.

The healthcare system claims to be all about patients, and sometimes it is, but that's not the thing that won't change.  "Patients" is an elusive notion -- when, what, where, how all keep changing.  It has led us wrong in many ways.

The North Star of healthcare should always be treating people like people.

Credit: Getty Images

Do that, and it wouldn't keep them waiting so long or so often.  Do that, and it wouldn't be making some decide between food or treatments.  Do that, and it wouldn't send some of them to collections (especially when they are already facing major crises).  Do that, and we'd hear less about arrogance and/or indifference from healthcare professionals/ organizations.

Healthcare isn't about helping patients feel better, or, at least, less bad.  It is, or should be, about --  as VanderWeele, et. alia recently put it -- helping people "flourish."  That is something that won't change.  Focus on that, and it will still be paying dividends in ten years.

As Mr. Bezos urged, be a missionary, not a mercenary.  Change your mind.  Take risks, swing for the fence, but be prepared to fail.  The changes ahead are things to be used to help address the things that don't change.  Blue Origin aside, this is not rocket science.  This is something that healthcare not only can do, it is something it must do. 

My list might be wrong.  It probably is.  Even if it is right, it may not be as specific as it should be, like Amazon's core goals.  So what's your list?