Behold the disruptive innovation! An entire industry can putter along for decades, steadily improving its products, services, and bottom line - only to be suddenly eviscerated by people from nowhere using simple, inexpensive, profoundly powerful techniques. Disrupters start by serving people whom established players don't even recognize as customers. Eventually, the newcomers learn so much so quickly that they can't help but radically outperform the incumbents. Take the phonograph: Thomas Edison installed his invention in the heads of dolls before it suddenly made saloon pianists and theatrical orchestras obsolete.
Harvard Business School guru Clayton M. Christensen has described this theory of industrial extinction in several books. In his latest, Seeing What's Next: Using Theories of Innovation to Predict Industry Change, the author encourages readers to spot vulnerabilities in the processes, values, and markets of seemingly invulnerable industries.
Intrigued by this challenge, I searched for the stupidest, most dysfunctional US industry I could find. The automotive and energy industries - beset by entrenched interests, sclerotic management, and stifling oversight - were tempting. But the worst has to be health care. Health care has every quality Christensen lists as dangerous: crippling regulation, overcharged customers, enraged victims with deep grudges, unnecessary goods and services, and a massive base of underserved wretches. The remarkably unhealthy US population blows more money on medicine than any other nation in the world, yet gets sicker anyhow.
Could a radically inventive disruption somehow render the whole tangled mess irrelevant? A system that eats 15épercent of the US gross national product is a broad field for disruptions. Some might bite a few links off the value chain, while others have potential to wreck the whole dysfunctional shebang. Let's consider a few scenarios.
Medical tourism takes off. US patients travel out of the country for everything short of visits to the emergency room. Offshore docs offer medical services that are faster, cheaper, and safer than anything available at home, obviating US doctors, clinics, pharmacies, insurers, and the federal government - just about everyone.
How likely is this? Medical tourism is already in full swing. Thailand is the golden shore for wealthy, sickly Asians and Australians. Fashionable Europeans head to South Africa for embarrassing plastic surgery. Crowds of scrip-waving Americans buy prescription drugs in Canada and Mexico.
Alternative medicine gets serious. Health food stores move out of the feel-good biz and focus on efficacy and marketing. Vitamin shops partner with massage therapists, acupuncturists, herbalists, dieticians, and physical trainers. Upscale operations collaborate with paramedics, nurse practitioners, and midwives. Together, they pluck the low-hanging fruit - casual doctor visits and innocuous prescription medicines.
Could it happen? Alt.med storefronts are everywhere, primed for walk-in traffic. Their customers have never trusted the medical establishment anyway.
Diagnostix "R" Us. Newfangled clinics offer a galaxy of cheap, simple diagnostic tests that show people what's going on in their own bodies. Counselors dispense information, support, interpretation, and follow-up advice. Under attack from an effective populist alternative, the absurdly expensive, often unnecessary lab-test machine withers.
This disruption is well under way. Over-the-counter tests now cover pregnancy, cholesterol, blood glucose, blood pressure, AIDS, narcotics use, and pollutant load. Meanwhile, walk-in imaging clinics offer MRI and CT full-body screening for the masses. It wouldn't take a genius to tear off this chunk of the medical complex and commoditize it.
Oldsters join the extropians. Aging boomers flock to longevity spas, which dispense radical rejuvenation procedures in the guise of elder care. The neglected elderly embrace biotech research considered outré by mainstream medicine: gene therapy, stem cell-driven organ regeneration, designer drugs that restrict caloric intake. Abandoned by their best customers, GPs and gerontologists close the blinds and go home.
What are the prospects? Sure, this notion would create a playground for transhumanists and life-extension quacks. But efficacy is moot - the booming elder population has little to lose and is too weak to sue with much enthusiasm. If zealots can deliver even vaguely effective anti-aging treatments to desperate elders, they could have a huge impact on the system. And some of us might even live longer, better, and with more money in our pockets.
Email Bruce Sterling at bruces@well.com.VIEW
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