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Doctors are sometimes blamed for the ills of the U.S. health care system, but our five-year research project in India and the U.S. revealed the opposite. Almost every high-performing health care organization we studied was led by a medical professional (something that academic research has also found).
What we found, while collecting case studies for our book Reverse Innovation in Health Care, is that these doctors are not just medical experts; they also have other qualities that make them very effective leaders. We call these individuals “doctorpreneurs,” and believe they are key to fixing the problems of the health care industry.
Doctorpreneurs have three important qualities:
- Medical excellence: First and foremost, doctorpreneurs are excellent doctors, with first-rate education and training. In professional organizations (consulting firms, universities, law firms), only a person trained in the profession is usually acceptable as a leader, and health care is no exception. Doctorpreneurs have credibility with the organization’s medical professionals, which makes it easier to implement bold or innovative strategies. And because they are first-rate doctors, they never lose sight of quality. But many hospitals, including poorly performing ones, are run by highly qualified doctors. What sets doctorpreneurs apart are two other qualities they bring to the table.
- Compassion: Doctorpreneurs are compassionate human beings who believe they have a responsibility to use their professional training to serve as many people as possible. This motivates them to worry about the industry’s bigger problems, such as improving access for those who fall between the cracks — be they the uninsured, the underinsured, or those living too far from medical centers. They view health care as a human right, and they empathize with the plight of patients. They pursue cost reduction aggressively, because, as one doctorpreneur told us, “if a solution is not affordable, it is not a solution.” In this way, compassion fuels innovation.
- Business discipline: The third key quality of doctorpreneurs is that they pay close attention to finances, capital spending, and management processes because they understand that if their organization is not highly productive, it will not survive and cannot achieve its purpose of serving the greatest number of people. They understand that charity is not scalable, but that a financially disciplined organization can scale up sustainably. This is true in both for-profit and not-for-profit organizations. Some doctors find it distasteful to talk about saving lives and saving money in the same breath — but not doctorpreneurs.
A doctorpreneur par excellence, in our view, was Dr. Govindappa Venkataswamy, known as Dr. V. He was 58 and already retired from an illustrious career in ophthalmology when he founded the nonprofit Aravind Eye Hospital in 1976. Not only were his medical credentials impeccable, he was also deeply compassionate. Inspired by the teachings of the great Indian philosopher, Sri Aurobindo, he was determined to end “needless blindness” in the world. His unbounded compassion was matched by a hard-nosed business discipline. He started Aravind with 11 beds in his home, and grew it to become the world’s largest eye hospital — one that performed over 1,000 surgeries per day, over half of them on patients who paid little or nothing.
Another example of a doctorpreneur is Atul Gawande. Gawande was recently hired by Amazon, Berkshire Hathaway, and J.P. Morgan as the CEO for their joint healthcare initiative. As a professor of medicine at Harvard, his medical credentials are beyond reproach. His engagement with public health issues in the U.S. and in poor countries, and his passion for writing about big health care issues, speak to his compassion. And his interest in organizational processes and efficiency — including a fascinating article in the New Yorker on what health care can learn from The Cheesecake Factory — shows that he understands the business discipline required to deliver quality health care affordably.
It is not difficult to find individuals who are good medical doctors. It’s rarer to find good doctors whose compassion drives them to do something about expanding access, even though idealism and noble intentions may have drawn them to medical school in the first place. But rarer still is the compassionate doctor who is also business-savvy. But it’s doctorpreneurs like these that we need to help usher in a new era in U.S. health care.