Health Policy

We Love Innovation. Don’t We?

BY KIM BELLARD

America loves innovation.  We prize creativity.  We honor inventors.  We are the nation of Thomas Edison, Henry Ford, Jonas Salk, Steve Jobs, and Stephen Spielberg, to name a few luminaries. Silicon Valley is the center of the tech world, Hollywood sets the cultural tone for the world, and Wall Street is preeminent in the financial world. Our intellectual property protection for all that innovation is the envy of the world. 

But, as it turns out, maybe not so much. If there’s any doubt, just look at our healthcare system.  

———

Matt Richtel writes in The New York TimesWe Have a Creativity Problem.”  He reports on research from Katz, et. alia that analyzes not just what we say about creative people, but our implicit impressions and biases about them.  Long story short, we may say people are creative but that doesn’t mean we like them or would want to hire them, and how creative we think they depend on what they are creative about.  

“People actually have strong associations between the concept of creativity and other negative associations like vomit and poison,” Jack Goncalo, a business professor at the University of Illinois at Urbana-Champaign and the lead author on the new study, told Mr. Richtel. 

Vomit and poison?  

A previous (2012) study by the same team focused on why we say we value creativity but often reject creative ideas.  “We have an implicit belief the status quo is safe,” Jennifer Mueller, a professor at the University of San Diego and a lead author on the 2012 paper, told Mr. Richtel.  “Novel ideas have almost no upside for a middle manager — almost none, The goal of a middle manager is meeting metrics of an existing paradigm.” 

You’ve been there.  You’ve seen that.  You’ve probably blocked a few creative ideas yourself. 

The 2012 research pointed out: “Our findings imply a deep irony.  Prior research shows that uncertainty spurs the search for and generation of creative ideas, yet our findings reveal that uncertainty also makes us less able to recognize creativity, perhaps when we need it most.  Moreover, “people may be reluctant to admit that they do not want creativity; hence, the bias against creativity may be particularly slippery to diagnose.”

In the new study, participants were given two identical descriptions of a potential job candidate, except that one of the candidates had demonstrated creativity in designing running shoes, but the other in designing sex toys (the researchers note: “the pornography industry plays a significant role in the refinement, commercialization, and broad dissemination of innovative new technologies”).  The participants explicitly rated the latter candidate as less creative, although their implicit ratings showed equal ratings.  

The researchers concluded:

Collectively, the findings strongly support our contention that implicit impressions of creativity can readily form, be differentiated from a traditional explicit measure, and uniquely predict downstream judgment, such as hiring decisions, that might be relevant in an organizational context.

This matters, they say, because: “the findings of study 4 seem to square with real world examples of highly creative people who were ignored until well after their death because their work was too controversial in its time to be recognized as a creative contribution…”

Umm, anyone remember Ignaz Semmelweis?

As the researchers warn: “The results of study 4 merely hint at the possibilities that await in many other embarrassing, stigmatized, or controversial domains within in which people might choose to do their most creative work but that their peers (and creativity researchers) might fear to tread.”  

E.g., if you’ve done your creative work in the health insurance space, that doesn’t necessarily buy you much credibility in the rest of the health care world – or if you’ve demonstrated your creativity in health tech, the rest of the tech world may still doubt your skills. 

——–

Well, at least our patent system, which protects intellectual property and helps fosters innovation, works, right?  Again, not so much. A New York Times editorial charges: “The United States Patent and Trademark Office is in dire need of reform.”  In the current Patent Office system, the Editorial Board asserts, “not only is legal trickery rewarded and the public’s interest overlooked, but also innovation — the very thing that patents were meant to foster — is undermined.”  

If there’s any doubt, just look at the price of insulin, which has been propped up by patent “innovations” that keep its price high after a hundred years.  “When it comes to protecting a drug monopoly,” The Times says, not limiting those monopolies to insulin, “it seems no modification is too small.”

The Patent Office, The Times suggests, needs to ensure that inventions are “truly novel and nonobvious, it must be described in enough detail for a reasonably qualified person to build and use it, and it must actually work.”  It also needs to challenge “bad patents,” such as those from so-called patent trolls, which exist not to innovate but to extort money from actual innovators.  

The U.S. is still, by far, the leader in patents granted, but not in scientific research papers or R&D spending per capita/% of GDP, which makes one wonder what all those patents are for. 

———–

Healthcare desperately needs innovation.  No one can dispute that; not anyone working in it, not anyone receiving care from it, not anyone who has had any exposure to it.  But healthcare also has a lot of middle managers, and middlemen, and, as Professor Mueller said, “Novel ideas have almost no upside for a middle manager.”  

Even worse, healthcare is always teetering on the edge of uncertainty – where’s the funding coming from, how much, what health crisis is coming, what’s the government going to do next?  The forces causing all that uncertainty should be driving innovation, but, as Professor Morrison’s 2012 research also found, “…uncertainty also makes us less able to recognize creativity.”  We have blind spots about what creativity is, who creative people are, and when and how we should incorporate those into our organizations.

Right now, healthcare thinks that EHRs and digital health – whatever that might actually be — qualify as innovation.  That’s enough, it believes; those are forcing change in ways and at pace healthcare is not used to and is not comfortable with. 

Too bad.

It has been said that if your company has an innovation department, it’s not innovative. If it has middle managers deciding which novel ideas get pursued, don’t expect real innovation.  If it is ruling out hiring people who worked on unusual projects (think sex toys), it’s rejecting creativity.  

Your biases against creativity may (not) be showing.

Kim is a former emarketing exec at a major Blues plan, editor of the late & lamented Tincture.io, and now regular THCB contributor.