by John “Jay” Crawford, MD
Ten years ago, the president assured the American public that if they “liked their doctor, they could keep him” and the federal government began its attempt to increase health care “quality,” lower “cost” and increase “value.” While there may have been a few minor (and typically fleeting) wins along the way, those of us who see patients day in and day out know the result. The truth is that the entire decade has been a major fiasco, which has now been objectively demonstrated in many peer-reviewed and non-political articles.
This revelation comes as no shock to most of us. Only the most naïve and hopelessly optimistic among us have seen any proposed initiative like electronic health records, Affordable Care Act or the Medicare Access and CHIP Reauthorization Act of 2015 and thought, “Hey, that will solve a problem that I have noticed!” The most common response I’ve witnessed to any new idea purported to increase value has been something along the lines of, “Whoever proposed this is either terribly misinformed about how health care actually works or knows it is bogus but thinks we can be fooled into believing it.”
Regardless of which it was, here we are in 2019 and things are wrong and unfortunately, we are either largely to blame or at least complicit — not because we were the people who rammed these programs of untested and unvetted ideas through legislatures, but because we kept our heads down, blocked out the noise and kept pushing the wagon every day. The discipline and work ethic instilled in an orthopedic surgeon through decades of the most challenging academics and the most brutal of work schedules creates people who, somehow, can always find another 5% effort to put into our clinics and operative schedules.
While we were working harder every day, we have each had epiphany after epiphany regarding how things could be made better. Those epiphanies have come more frequently as problems have gotten bigger and more pervasive. Each of us can now easily imagine a number of solutions that would improve the lives of patients and even ourselves. However, relatively few of us have acted on our epiphanies. Most believe either that they are too busy or that no one will listen, or that building a new solution like a software package that improves office functions or designing a new implant or tool is simply too complicated or requires formal education like an MBA.
That line of thinking is wrong. The cavalry is not coming over the hill to save us. Neither the policy makers nor the software designers in Silicon Valley have been to a doctor since they got their booster shots at 10 years old. They have no idea how health care works. The real solutions have to come from us, which means that each of us needs to answer the phone, take the risk and build the thing. You can do this — I guarantee it.
The Business-Minded Surgeon is not me — it is us. We are the ones who actually know the business. We are the ones with the energy to build, and we are the ones with the capital to invest. There are 25,000 orthopedic surgeons in the United States and each of them has untapped entrepreneurial ability and motivation.
Dozens of us across the country have already started. We started OrthoFounders in 2018, a network of orthopedic surgeons who have founded or significantly participated in the development of a company that is solving the participating surgeon’s actual problem and, thereby, every other surgeon’s problems, too. We are calling you to join. The time to build, to participate and to fix is here. You have what it takes.
This blog shall henceforth belong to the OrthoFounders. Every month, we will bring news from one of our members discussing their problem, their solution and their entrepreneurial path. Whether you have started already and have questions about funding, partnerships or traction, whether you have sketched your solution on the back of a napkin that you left in your jacket pocket or you have been losing sleep over a problem that you know can be solved, we are here and want to hear from you. Every surgeon who solves his or her own problem will solve other surgeons’ problems, too. Let the second wave of health care innovation begin!
John “Jay” Crawford, MD, is a co-founder of OrthoFounders and founder of nextDoc Solutions, a software company that maximizes return on invested work effort for orthopedic surgery practices.
Disclosure: Crawford reports no relevant financial disclosures.