Since the days of my dad’s company, MultiQuest, I’ve loved creating software. With much excitement, I saw the minor contributions I made to MultiQuest’s software reach an international audience of users. They then used our tool to develop their own complex software more easily and quickly. Since then, I’ve taken a crash course in the biomedical arena and got turned on to medical devices.
I really want to go back to making products, but this time, in the medical device industry. I’ve been a fan of Steve Jobs for a long time. In the past couple of years, I realized that I really want to be like Steve, but for medicine. Steve Jobs’ “simplifying antidote” was really powerful for making computing easier, but in all its complexity, medicine is probably resistant to this antidote.
After Steve’s passing, I read a really well-written post by Forbes’ Matthew Herper on why Steve’s magic doesn’t work in medicine:
Hospitals could use someone to stitch all the gadgets together, and make it all perfect, but there simply may be too much going on for this to happen. [...] Innovation [in medicine] has been technical, and hard to understand, and only physicians and surgeons can grasp it. And we don’t reward it as much as a society: unlike in tech, little of the money in medicine goes to the actual innovator. There are 50% more billionaires from tech than from health care, and they are far richer.
I think there are some great efforts to make the healthcare system simpler, such as with electronic medical records. When it comes to embracing simplifying technologies, though, new devices face issues with reimbursement (discussed a bit more in a previous post, and on Medical Devices Today). Steve Jobs was lucky that he could make products without needing to seek approval from the numerous stakeholders present in medicine (e.g., insurance agencies, doctors, regulatory agencies, government, patients, etc.). Understandably, regulations are stricter on medical devices, but this gave Steve and Co. a lot more freedom to innovate.
Is the difficulty with simplifying medical technologies then more a problem with the healthcare system and policies in this country? Xconomy covered a recent PwC report saying that the US’s medical device leadership is in jeopardy. According to the study’s author, the decline is partly due to these regulatory and policy issues:
In the old world, the FDA was reasonable to deal with, and as long as you followed the rules, you could get an approval [...] Then if you brought it to market, insurance companies would pay for it based on a reasonable assessment of the value you would bring, and the cost it took to bring it to the market. That whole calculus has been thrown out the door.
The barrier to entry in the US device market is making innovation expensive, and it really seems to be eroding our country’s leadership position in this area. Herper makes a great point that our society needs to celebrate (and fund) fundamental work. We can’t have any more stories like the one he cites in the Forbes article:
I’m haunted by a story I heard once about a biotech industry lobbyist who went to see a congressman and was told, “You guys don’t do innovation. The iPad. That’s innovative.” [...] As a society, [...] we overlook the work that is actually foundational.
Setting the congressman’s (and possibly the public’s?) ignorance aside, Herper is right. But, innovation in medicine isn’t just hard because medicine is complex. Getting an innovation to this market is just as tough as making the innovation itself. This isn’t good news for aspiring Steves of Medicine like me – we desperately need a Steve Jobs of healthcare/regulatory/public policy before a Steve Jobs of Medicine can emerge.
I just went to the Biomedical Engineering Society annual meeting, and saw a lot of amazing things that scientists and engineers are making. I think it’s just a matter of awareness and communication – more than many other fields, medicine is like football in that it’s a team effort. As long as innovators are in regular contact with policy makers, it’s going to be pretty exciting to see how new technologies can develop a more elegant approach to health care that Steve would have been proud of.