Kent Bottles: Three Books You Must Read If You Lead A Health Care Organization

“If you are not confused, you don’t know what’s going on.”  Jack Welch

“My life has been filled with misfortune, most of which never occurred.” Mark Twain

Anyone charged with planning for the future of a hospital, medical practice, health plan, pharmaceutical or medical device organization should resonate with the above two wise sayings.  If you don’t, you have just not been paying attention.  I am as confused and disoriented as anyone in the industry. (http://icsihealthcareblog.wordpress.com/2009/06/24/kent-bottles-doctors-patients-health-2-0-web-3-0/)

However, three books have recently made me think a lot about how to capitalize on the future and stop wringing my hands in anguish and fear.  They are (in no particular order): The Innovator’s Prescription:  A Disruptive Solution for Health Care by Clayton M. Christensen, Jerome H. Grossman, and Jason Hwang (New York: McGraw Hill, 2009), Here Comes Everybody:  The Power of Organizing Without Organizations by Clay Shirky (New York: The Penguin Press, 2008), and Free: The Future of a Radical Price by Chris Anderson (New York: Hyperion, 2009).

Christensen is a Harvard Business School professor who has studied, lectured, and written about how industries get transformed when a disruptive innovation makes previously expensive products and services accessible to a larger population.  Think Ford being disrupted by Toyota being disrupted by Chery (electric car).  Or think AT&T being disrupted by Cingular being disrupted by Skype.  Or think Digital Equipment mini- computers being disrupted by Dell laptops being disrupted by RIM Blackberry and iPhone smart phones. You get the picture.

What Christensen does better than most consultant interlopers is actually think long and hard about how the current business models of hospitals, medical practices, health plans, pharmaceutical and medical device organizations are not sustainable.  I will let you read the book to see if you agree with him or not, but at least he makes you think about how to plan for the future.  Christensen concludes that large employers and organizations that combine providers with a health plan are the most likely to be the big winners when health care finally does get disrupted.  His other important conclusion is that most of what we in health care get all excited about as innovation is really not disruptive innovation.  We ain’t seen nothing yet.  He may be right or he may be wrong, but you have to read this book and think about your organization’s future.

I first heard about Clay Shirky’s book when I heard him give a keynote at a Health 2.0 Conference in San Francisco organized by my Twitter buddy @boltyboy.  What Shirky does is give you an organizing theory about why Patientslikeme, CuringTogether, DiabetesMine, and all the other patient social media sites will surely transform medicine and the doctor patient relationship (http://icsihealthcareblog.wordpress.com/2009/07/08/kent-bottles-here-comes-everyone-on-web-3-0health-3-0/).

We doctors are used to dealing with individual patients.  We are now seeing aggregated patients who have googled their symptoms, come up with a working diagnosis, and chatted with other patients world-wide to come up with treatment plans and even research projects with no input from doctors and hospitals and other experts.  Yes, they will sometimes get the diagnosis wrong and they will sometimes not understand why their drug of choice is a bad idea, but they will be involved in their own care a lot more than many doctors would like.  Woe to the strategic planner who does not take Shirky’s approach of promise, tool, bargain seriously.  You need to read this book.  I am doing it for the second time.

@LeeAase, Mayo’s social media maven and wisecracking lecturer, turned me on to Anderson’s book about free (http://www.slideshare.net/LeeAase).   Remember how Christensen taught us that AT&T was disrupted by Cingular, which was disrupted by Skype?  Well Skype is free, and Anderson explains how they can do that.  I think I now even understand the difference between the four types of cross subsidies (direct cross-subsidies, the three-party market, the freemium, and the nonmonetary markets).  The tables scattered throughout the book are easy to understand.  They deal with: How Can Air Travel Be Free? (@kentbottles; Where is the health care CEO with the “mad ideas” “passion” and “imagination” of Ryanair CEO? http://bit.ly/8AerAX); How Can a DVR be Free?; A Test of Free in Daily Life; How Can Millions of Secondhand Goods Be Free?; and How Can A University Education Be Free?  You get the picture.  And as Lee Aase taught us in a recent ICSI lecture, you can develop a social media department in a hospital by using Twitter, Facebook, YouTube, blogs, and podcasts, and it is practically free (http://social-media-university-global.org/). And Anderson even delves into the psychology of free which explains why it is such a great and powerful marketing tool.

I now have a confession to make.  I read all of these books the old-fashioned way.  I marked up and underlined a real book that I bought secondhand on Amazon.  I just have not made the plunge to the Kindle.  I know I will probably get one someday, and I know Jeff Bezos reads a Kindle in a plastic bag while bathing (http://www.nytimes.com/2009/12/06/magazine/06fob-q4-t.html?ref=magazine), but I still worry I might get a shock (http://www.geeksugar.com/2867733).   Anyway, if you are planning for how your health care organization will survive in the future, you better understand what is in these three books.

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