GUILLERMO WECHSLER

January 10, 2007

A New Perspective on Health Care Challenges

My experiences in the health care industry are limited. I helped a market research group for AstraZeneca to develop a strategy for a new cancer drug (I learned a lot about what happens in markets with sharp asymmetric information -between patients, patients' families, drug producers, physicians, health providers...-and with highly fragmented, conflicting, and largely denied role identity struggles in physicians' professional environment).

I also worked with AstraZeneca to deliver a proposal to develop a Multicultural Marketing Capability able to develop customized services and drugs for different ethnicities with distinctive patterns of health conditions. And there was a project to improve some product development practices at Genentech, alongside a few other projects with health providers.

Health care industry is a captivating place to spend professional energy. It produces simultaneously incredibly value and astonishing waste, visionary ethical leaders and opportunistic mercenaries, social recognition and social criticism. It is the space in which the discourses of science, medicine, engineering and business compete in leading to a better future. But as happens in any conversation, the wrong framing can produce bad consequences.

Many months (years?) ago, I read a HBR article by Michael Porter and Elizabeth Olmsted Teisberg, published as a book in 2006, “Redefining Health Care.” They made a magnificent contribution to understand the “framing” problem in thinking about the health industry. Simple and powerful. They made a thorough diagnosis of what they characterize as a wrong structure of competition in the industry (zero-sum competition) and they proposed a set of design principles that could shape a space in which new valuable service practices could thrive. I strongly recommend the book and will be happy to engage in conversations about it. The starting point of good service design is achieving a rich articulation of the underlying anomalies producing the mess, declaring a set of design principles to create the adequate orientation and language, and conceiving a new possible reality that unsettles current complacency. They did all of that.