Doctors working in other industries such as healthtech (or medtech) find themselves considering priorities that weren’t discussed at medical school. This can be a challenge, but the CMO (Chief Medical Officer) must never forget why they are being employed as a doctor in that organisation.
The raison d’être of the CMO is to ensure the company’s product is medically sound in terms of regulation, accuracy and safety
Here I describe the key challenges facing medics in healthtech, and how I approach them.
1 First do no harm
In undergraduate curricula we are taught to put the needs of our patient above all else. But that fails to acknowledge the complexity of the realities almost all doctors face daily with limited resources and demands for efficiency.
In it’s modern-day Hippocratic oath, the World Medical Association declaration of Geneva pledges that “the health and well-being of my patient will be my first consideration”.
In the NHS when we ask Mrs Jones to return next week with her list of 10 problems, because you don’t want every subsequent patient that afternoon to start 30 minutes late, or when we decline to prescribe medication because it’s cost-effectiveness has not yet been proven according to NICE — National Institute for Health and Care Excellence, we aren’t thinking of “my patient”, we are thinking of the wider community. This conflict in priorities is a challenge for all doctors.
In the private sector that challenge is even greater, because the conflict is no longer “my patient” vs community, but often “my patients” vs company profits.
The key is to recognise that you are working there to prevent harm to patients. If there is a reasonable risk that a patient will come to harm, regardless of “legal fault”, you have a moral duty to prevent that harm.
I have been told that the medical safety and accuracy of our product doesn’t matter because we can add tick boxes to pass the responsibility onto the patient. Do you think that would stand up to scrutiny by your own conscience, or in coroner’s court?
2 Be part of the team
I have seen horrendous failures of legal and medical teams where they are positioned in an ivory tower on the edge of an organisation. The rest of the company felt intimidated by them and viewed them as a blocker to any projects that they had. This resulted in projects being hidden from them until they had to have final sign off, at which point any potential changes had a negative impact on both timescales and the moral of all involved.
Being open, accessible and an integrated part of the overall company team means that regular check-ins can be made, working relationships built and a mutual respect and education develops over time to ensure smoother, and safer, projects.
Don’t be the “medical team”, be the “medical voice” integrated into the company team.
3 Listen and explore
First you’ll need to listen to your colleagues. Ask the technical team why are they recommending this solution, is this the only option? Also ask the commercial team, maybe competitors are doing it; and if so how? Maybe competitors have found a safer way to do it.
Try to assess the perceived benefit of a new feature that you may find risky. Perhaps that benefit can be achieved via a safer route.
4 Recognise team knowledge
Just as patients like to hear their own words said back to them in a consultation, so do product managers and developers as it demonstrates to them that you have listened and are putting yourself in their shoes.
All points of view are valid, you are building on the knowledge of others, not erasing it.
5 Build on the knowledge of others
Now that you heard the points of view of your colleagues, listened to their knowledge in their respective fields, and understood their reasoning and their needs, you can build on that knowledge with your own.
Remember that they know their field much better than you, that’s the power of a multi-disciplinary team.
6 Educate the team
Once you have learnt from your colleagues, they can learn from you.
Medical principles — Explaining what the medical significance is of the proposed solution demonstrates that you respect them enough to take the time to explain things, it also teaches them the principles that may apply next time, and it helps them to understand the importance of your point of view on this project.
Show the guidelines — Using nationally recognised guidelines as the basis for your recommendations helps you to be reassured that you are giving correct advice, and it provides irrefutable proof to your colleagues that you are following established principles of state care.
Challenge presumptions — It may be the case that people are doing something because “it’s always been that way”. Explain why the status quo isn’t always the best approach.
What’s the harm? — Demonstrating the real harm that can come to real people if a project isn’t clinically sound can often focus the team on the importance of the project.
A medical lead that understands some principles of the tech working with a technical lead that understands come principles of the medicine creates a collaborative working environment and a better product.
7 Focus on the prize
Now that you’ve gained a mutual level of respect and understanding, focus on the ways that the goals of the project can be achieved. Look at what you are trying to gain at a granular level, to really pick out from the detail what will be considered “success”.
By picking apart project goals you find the true essence of what you are trying to achieve, then work backwards as team from that point.
8 The product is health, not tech
Those health technology companies that succeed are those who focus on the very end product. Apple doesn’t sell iPhones, it sells an experience an revolutionary way to manage your data and communicate with the entire planet. Nike doesn’t sell clothes or shoes, it sells ambition and motivation.
Remembering why we are all here can help us leave our ego at the door. We are here to improve the health of patients, not create amazing technology that we can all geek-out over.
Repeat this 3 times every morning: “The product is HEALTHIER PEOPLE. The technology is just the route.”
Now that doesn’t mean that the technology doesn’t matter, it does, it really does. If adding a function X will ensure that patients use the app more, which will lead to better Y health outcome, that function is important and powerful.
9 Frame the benefits
Sitting in a, often virtual, room discussing the conflicting priorities of health and tech can be very abstract. Framing the benefits of excellent clinical products can help achieve buy-in from all levels of an organisation. Healthtech company success requires:
A reputation for excellent clinical care
Patients having awareness of the effects the product is having
Industry seeing the benefits to health, so that uptake is catapulted
National organisations seeing the benefits to health so national and international adoption of the product occurs
Reduced risk of patient harm, and resulting reputational and financial damage
10 Enjoy yourself
Being a doctor in healthtech can be tough, and lonely. But you’ve made this choice for a reason. You have a rare ability to speak to so many different professionals each day, you’re always learning things beyond medicine, it’s fast-paced, it’s exciting and it’s fun! The challenges described above are within your power to turn into opportunities.
Be grateful for this opportunity to be at the forefront of medicine!
Well these are my thoughts. What are yours? Do you agree or disagree? Do you have anymore tips?
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