Culture Conflict: Tech & Medical, Latter “Immune” From Propaganda (Opinions) in Medicine
Why Misinforming Physicians Are Treated Worse Than Traitors in Medicine
Friends from tech have asked me why some physicians will very publicly shame other physicians in their ranks; it’s unexpected to all given that civility and decorum are still key features of medical culture which distinguishes it from other industries (and a large part of what makes in my view, medicine a wonderful industry for a career and a topic for a different post). I spent a decade at Johnson & Johnson in a dozen disease states before “immigrating” into medical technology and the tech sector in general.
In each instance of public shaming, the physician under attack appeared to misrepresent data and contribute to medical misinformation.
What’s Considered “Evil” in Medicine
What’s the big deal you ask? Physicians take great pride and rely on one another every day to adhere to a similar set of values. One of those is the oath they take: “first, do no harm.” Physicians who appear to violate this oath by contributing to harm are thus seen as worse than traitors, even evil in a historically tightly knit industry with strong respect for ethics. I’ve been reflecting on the gulfs between tech and medicine for several years in terms of not just building product and driving demand and then adoption for it at Medigram; but also in my drive to identify and help close the enormous knowledge gaps that have thus far prevented technology from successfully transforming medical care.
In Medicine Your Opinion Probably Doesn’t Matter; Bring Data
One huge difference I notice is the use of opinions in the tech industry. In medicine, opinions only matter once they’re underpinned by earned credibility to have an opinion in that subject: board certified cardiology, neurology etc. Short of that, physicians want to know only the opinion of the medical societies that educate said specialists. All other opinions are meaningless. Bring only facts or data. It’s so extreme, that a person that brings a “cult of personality style” that one often sees in tech with their opinion, that will really turn off stakeholders in medicine and they will likely have trouble accessing medical stakeholders or earning respect from them widely. I observed with a friend who, like me, straddles medicine and technology; we both marvel at how much the tech industry is like politics. There is so much propaganda and that propaganda can have a huge impact on business in tech specifically. Though propaganda has the opposite and extreme negative business impact in medicine.
Propaganda Doesn’t Work in Medicine and is a Huge Waste of Resources
The reason why I believe that small companies can succeed in medical tehcnology is that propaganda can and will backfire in medicine; it doesn’t matter how many PR people a company has, 5000 or more isn’t unusual for tech companies. Nothing they put out will be paid attention to in medicine. So you don’t compete on dollars and resources in aggregate. In medicine, propaganda is just noise to be ignored. The gulf came to a head for me personally when a tech colleague marveled at me “You really care about truth!” The inference in the discussion is that truth in tech business isn’t supreme. I was taken aback and agreed by their request to read ‘Win Bigly” by Scott Adams so I could learn why propaganda style communication is critical in tech business. As a fan of Dilbert, I didn’t mind this assignment. What struck me though is; I’m actually married to the problem and inspired in my work by my muse and dear husband, Art a neurologist and serial healthcare executive who needs what we build at Medigram, a quick, medical grade, secure way to send and receive information no matter where he is. If Art couldn’t count on me to be truthful, we wouldn’t have what we do in terms of a real marriage, as opposed to what some suffer, a “marriage in name only,” or MINO.
A Great Article on the Culture Clash of Tech and Medicine by a Physician Who Works in Tech
Researching this topic, I found this article and have pasted my favorite highlights below from “Understanding the Differences between Medical Culture and Tech Culture” by Dr. Jill Hagenkord.
Relationships built on trust and respect with any medical stakeholders hinge on trusting one another’s truthfulness and are table stakes for medical business . That’s why the idea of “hide any flaws” in the above table is anathema in medicine. This is further reason why we at Medigram are working towards developing a company building model that is based on understanding and respecting the culture of medicine and pairing that with technical excellence. This cannot be done in either legacy technology firms or historically healthcare only firms in my view.
Below are my 5 favorite excerpts from her post:
“Health tech experts lamented that the Silicon Valley tech ethos of “move fast and break things” is not being counterbalanced by the healthcare principle of “do no harm. (Why everybody gets duped by hot health and science startups, June 2019).”
“Company could have been more successful more quickly if the company had had an earlier understanding of the expectations of the healthcare industry and sensitivity to healthcare culture. I observed this same phenomenon in many of the health tech startups evolving into and out of existence around me.”
“Realize that in order to respect a different culture, it’s important to learn about why that culture is the way it is.) Too often, my tech teammates did not reciprocate my willingness to understand their culture (by understanding medical culture.) This limited the company’s ability to design appropriate products, close deals, and compile realistic financial projections. It costs real time and real money.”
“There are multiple, very powerful stakeholders in health care — insurers, regulators, physicians, professional societies, pharma, and patient advocacy groups. Consumers often don’t feel like they should have to pay for legitimate health products out of pocket, so simply delighting consumers and getting them to vote with their feet is not enough to achieve widespread adoption, let alone topple the incumbent system. Unlike other industries, a direct-to-consumer product can’t circumvent the incumbent stakeholders. That’s because consumers will inevitably take the results of their health products to their healthcare providers. If the healthcare provider says, “What is this? This is junk. You’ve been swindled,” it doesn’t make for a positive consumer experience. The flywheel cannot gain momentum. You simply have to understand the values and social mores of the healthcare stakeholders to win.”
“Finding the Right Balance
We need to find the right balance of healthcare and tech cultures to get impactful products quickly and responsibly, and to successfully usher in the much needed disruption of the incumbent healthcare system. The longer we delay prioritizing this balance, the longer we all have to live with the current broken system, and the longer we have to watch billions of dollars wasted on health tech startups that are doomed to fail because the founders do not understand healthcare culture — both are pretty unbearable!”
The mission of bridging tech and medicine is not for the faint of heart and the enormous effort isn’t worth it for most people nor most companies; though now is the right time. We wrote this book to help.
By Sherri Douville, the #1 ranked medical market executive worldwide and #1 ranked in mobile technology categories (mhealth, iOS, Android) in the U.S. on Crunchbase and best selling editor/author, Mobile Medicine: Overcoming People, Culture, and Governance
