Staying the Course

“Success, therefore, is not about the episodic, momentary victories, though they do play a role. It is about the longer view of incremental steps that produce sustained progress.”

-       From Atul Gawande in “The Heroism of Incremental Care”, The New Yorker: Annals of Medicine. January 23, 2017


I have always been struck by the cultural differences between business and medicine. I spent almost 10 years in pediatric cardiology – and though it definitely has those “auras of heroism” where single interventions have life-saving impact, it is at its core a field of anticipatory guidance and preventive maintenance. Physicians, nurses, physical therapists – the cross-section of health care providers – understand that a child ostensibly has a lifetime yet to live. And so decisions are made carefully and thoughtfully; most importantly, small, incremental gains are big wins because they are accomplished in the context of the larger vision of an adult human being. Sustained progress.


Balancing the near term win with the long term vision is a challenge – the near term win helps secure capital and entrains enthusiasm for the imminent achievability of the long term vision. Make no mistake, though, that our greatest challenges in healthcare – and therefore greatest opportunities – depend on that long term vision. Whether it’s curing cancer, predicting disease onset, or even creating artificial organs for transplant, incremental successes (and failures) are what lay the groundwork for the big vision’s ultimate realization. Healthcare is always said to move at a glacial pace relative to other industries – a somewhat disparaging sentiment, but one that I view through a different lens. At its core, healthcare impacts human beings in a way like no other industry. Disease is the great equalizer – it doesn’t play favorites and it doesn’t discriminate. Healthcare is an industry where every single human being is the potential end-user. In this case, getting it right is important.


As the entrepreneurship sector that supports the healthcare industry, we are asked to take risks and move quickly – failing often and fast are signs of positive progress. We want to see the change quicker than the change is often ready to happen. But happen it will, and it is our responsibility to ensure that it happens in a way that supports quality care for individuals – care that is efficient, cost-effective, and personalized to the patient. Whether you are developing a device that enables home-based surveillance and therapy, creating algorithms that potentially risk stratify populations, a new diagnostic to detect disease, or a service that aggregates health and cost data, remember always that your solution is part of the long term vision of healthcare’s success. That vision is not a point in time, but a living objective. As Jonathan Bush, CEO of athenahealth, said, “Once we bring humanity to the way we innovate, regulate and share across healthcare, we’ll have navigated that perfect storm to push healthcare to new heights.”