“Dammit Jim, I’m a Doctor!”: The Biggest Reason it’s Difficult to Innovate in Healthcare!


Medicine is inherently risk averse!

Of course, we want predictable and repeatable results! As a physician, I would love to know with certainty what treatment would work perfectly each time.

My medical school and residency training underscored the idea that failure is synonymous with patient death, or grievous injury or (scary still) litigation. I’m not sure it was even stated outright — it was somehow just in the ether, and we all absorbed the lesson.

If predictable success is the desired outcome, unpredictable failure is the opposite — and therefore the worst possible scenario. Actually, knowing that something reliably fails is a blessing — we know then never to try it. We can even seek to understand why, and build on those lessons.

In innovation, however, we are purposely trying something we haven’t tried before, which of course leads to unpredictable outcomes. Sometimes that outcome is a complete failure. Therefore, to find the new path, we must be willing to take risks, and embrace the possibility of failure. Certainly, any innovator would prefer to come up with brilliant success after brilliant success, but we know the likelihood of that is extremely slim.

How then can we innovate in a culture that is so afraid to fail? This is the dilemma we face!

The solution: We must adopt a different attitude towards failure. Failure is not only expected, it is welcome. When asked how he felt about failing, Thomas A. Edison is credited as having said:

At the very least, we can chalk up any given failure to eliminating a possible solution (or family of solutions). At best, it may lead us to a more effective solution in the process. Importantly, even if some exploration doesn’t lead to a solution to our problem, we may stumble across an idea that may solve someone else’s problem.

Diagram A

In 1968, that very thing happened to Dr. Spencer Silver, a 3M scientist, who was hard at work trying to invent a super-strong glue, when he came up with the exact opposite. He didn’t dismiss it outright, rather he suspected that it was a “solution seeking a problem” but had no idea what that problem was — so he advertised it within 3M. It wasn’t until 1974, when Art Fry, a colleague, frustrated that his bookmarks were constantly falling out of his hymnal, cleverly applied the weak adhesive to the back of one. It worked brilliantly! He then thought of applying it to note paper, and it just happened that the lab next door used yellow scratch paper. Et Voila! The Post-It note was born! Interestingly, the product that the

company is best known for was a complete fluke — arguably an abject failure!

This is where non-linear thinking becomes really important!

Diagram B

Linear thinking leads us to reliable, reproducible results! Traveling in a straight line from point A (diagram 1) will lead us ultimately and always to B. This, as I mentioned earlier, is a worthy goal in medicine. It would be chaotic if every time I prescribed a medication, I had no idea of what the effect would be. And it is only a serendipitous accident that leads us to a happy discovery. This is what lead Sir Alexander Flemming to the discovery of Penicillin, when mold accidently grew on his petri dishes.

Diagram C

Solution: Relying on happy accidents is not, however, a good way to come up with novel ideas and approaches to a problem. To do that we have to purposely get off the path. Play! Be creative! Try things we haven’t tried before! Be comfortable with exploring ideas that may just fail. Because in the process we may discover “D” the true solution, which although is only a slight deviation from B, we might never see. And we may in the process discover “C” — the glue behind Post-Its.

Feel free to connect with me on LinkedIn. www.LinkedIn /in/andrewchacko/

J. Andrew Chacko, MD, MSE, FAPA

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Physician. Design Thinker. Leader. Teacher. Medical Futurist.