Digital Transformation and the Health Care Biz: My (Somewhat Skeptical) Takeaways For HBS

By DAVID SHAYWITZ, MD (2)

I’m deeply skeptical that I have much knowledge to impart to Harvard Business School (HBS) students.  After all, they’re the ones clever enough to pursue a two year advanced degree (“six months of education crammed into two years,” they joke), while across town, my classmates and I ran gels, plated cells, memorized structures, and took call for a decade or more (in some cases) — and all for the privilege of eventually working for our fleece-vested colleagues (see also this 2011 Scott Gottlieb piece, and my 2012 Forbes post).

Even so, I was recently invited to appear as a guest on a new podcast out of HBS called “Under The Datascope,” where I answered questions about my experiences and perspective as a physician, scientist, technologist, drug developer, and investor. The episode (here),released today, is part of a series hosted by Gabriel Eichler and sponsored by the Kraft Precision Medicine Accelerator (Go Pats!) at HBS, featuring interviews with people working on and thinking about data, analytics, and precision medicine.

There’s a lot of content packed into the nineteen minute episode, and I thought it might make sense to capture some of the highlights – though I suspect the entire episode, and the series more generally, is likely to be of interest to readers.

Biomedical entrepreneurs drive science into durable application. After struggling during my clinical and research training with the persistent gap between promising science and clinical application, I came to appreciate that biomedical entrepreneurship represents the distilled essence of the translational impulse. (See this 2005 Nature Biotechnologycommentary, for example, this related version that was published in the San Francisco Chronicle, and this and thisfrom Forbes.)

Biomedical entrepreneurship requires humility and humanity, not tech fetishization and solutionism. Driving science into application requires not only the best (more precisely, the most suitable) technologies that are available, but also a deep sense of, and respect for, the complexities of biology and what I described as the “humanistic center of medicine and patient care.”  (Regular readers will recognize this as a recurrent theme of this column — e.g. this 2011 post, “What Silicon Valley Doesn’t Understand About Medicine”).

Good doctors have always customized care. The mantra of precision medicine – “right drug for the right patient at the right time” – is not a radical new idea, peculiar to the molecular age. Admirable doctors have long tried to individualize treatments based not only on the biology of disease, as best it could be understood, but also based on the physician’s knowledge of the patient’s circumstances and preferences. It’s also critically important not to be excessively reductionist, and to recognize a person isn’t just the sum of their molecular mutations; everyone exists in a much broader context. See hereand here as well.

Continue reading