Things & Thinks Half & Half Ed. 1
One of the unintended consequences of writing this fortnightly newsletter over the last year has been a (dis)proportionate increase in learning new areas of healthcare innovation and questions/curiosities related to these areas. I have also been pleasantly surprised how this has generated new topics for discussions.
Hence this month onwards, Things & Thinks will be in a dialog with a leader in healthcare innovation and we will call it Half & Half. Through this dialog we will get to know some thoughts on healthcare and some on personal leadership journeys from these fascinating people. I hope you like this new style and format.
Aakash Ganju joins for the inaugural edition of Half & Half!
Aakash describes himself as a “Father, Husband, CEO of Saathealth, entrepreneur and someone who is reimagining health and education for our future”’; he has been my mentor for several years and I am super-thrilled to have him as the first guest!
T&T: Hi Aakash, thank you for agreeing to be the first guest here on Things & Thinks! Let’s start with your backstory?
AG: I grew up in Mumbai, a decent student from a middle class family; I made through college and then went into medicine. I completed graduation and finished my post-graduation in pharmacology. I somehow knew clinical practice wasn’t for me and I chose to work in the pharmaceutical industry, more so as it seemed like a good place to expand my horizons. I was fortunate to work with fantastic people around the world, to shape my thinking and how I approach my work, while working first at Pfizer and then at Johnson & Johnson.
About 9 years ago, I decided to take the leap and pursue my entrepreneurial leanings. Since then, I have worked at the intersection of healthcare technology and consumer focused communication. My passion is how do we reinvent/rethink health for the future and my belief is to create an adaptive learning space for health consumers. I am equally passionate about the same proposition about education. In a nutshell, how health and education should be in future; my training is in health and my passion is in education.
T&T: Is there something you learned in college that’s proved almost wrong?
AG: Not sure about something that’s proved ‘wrong’, but one realization has been how much ‘unlearning’ I had to do. This question also reminds me of a story from my clinical research days at Pfizer. I was attending a meeting with physicians and a colleague was presenting & during the Q&A, she deftly managed to answer the questions; the interesting thing is when she was not able to answer some of these questions, she was comfortable saying ‘I don’t know’. The biggest unlearning was, throughout our entire school and college days we were never encouraged to say ‘I don’t know’! I continue practicing being comfortable with uncertainty. I am now a lot more comfortable saying ‘I don’t know’, having discovered the liberating power of that phrase and this has helped me immensely dealing with uncertainties in life.
T&T: Do you see this happening in our professional lives more often? Are healthcare leaders more comfortable saying I don’t know?
AG: Healthcare is comparable to the other spheres of life. If saying ‘I don’t know’ makes the person somehow put at a short-term disadvantage, people in the business world increasingly will not do this. So, no it is still not that common.
T&T: What are you deliberately practicing these days?
AG: I run, not so much for physical exercise but more for emotional and mental space; for me, running is very metaphorical knowing that there is no immediate gratification while running. It’s a space where my mind can freewheel; during the COVID-19 lockdowns it also helped me decompress and reduce my grumpiness!
T&T: What’s something new you’ve learnt about yourself in the past 3–6 months?
AG: I think it’s less about learning new things about myself but more solidifying my convictions about what I believe. So, I knew that I am someone who valued independence of thought and independence of action, but I think when you go through tough times, you are pushed to challenge yourself. I came across a quote from Bob Dylan about success recently, it goes “if you get up in the morning and if you go to bed at night and in between you do what you want to do, that’s success!”. That resonates with me. So, one of the things that has really solidified in the past few months is how important autonomy of thought and action is for me because it’s been a challenging time. I am constantly saying that ‘this is the last one that I want to trade off’ on when making choices.
Another thing I have practised is my leadership style. I think I’m more of a ‘nurturing leader’ which is great at a certain stage of a professional journey, however may not be good at other stages. I’m learning to balance off the autonomy and the direction I must provide in my style. I am trying this with not only my team but also with my kids!
T&T: Let’s talk about healthcare; what will be the biggest challenge for healthcare in the next decade?
AG: Figuring out a path from where we are to where we go; everyone knows healthcare in future needs to be driven by technology, by data, by health consumers. I feel everybody is struggling to figure out the path because the legacy ecosystems still continue to be dominant. Think about it-our approach to healthcare practice today is not very different from 150 years back- I feel discomfort, I go to a building somewhere, I submit myself to a physician’s hands and decision making. There are some changes here and there-telemedicine and so on. It has not fundamentally changed, as it has in other fields like shopping, like air travel. Healthcare is still thinking in incremental language and we are still waiting for exponential shifts. That’s the biggest change. Without this change, we cannot afford the increasing costs and increasing resource demands in healthcare.
T&T: What’s the best piece of advice you could give to someone starting their first healthcare job now?
AG: Think about who you are going to work for-your hiring manager, your team, things you will learn with them both on the local and global scale; This may sound clichéd but I feel these things are much more critical than your salary, position and so on.
A newcomer starting in healthcare should know that any decision you make in healthcare, the number of stakeholders is huge. So, a job in healthcare will have more complexity as compared to some of the other jobs. This can be a litmus test for newcomers, if you can learn dealing with this level of complexity in your first job, you will end up learning a lot.
T&T: If you are asked to bet on something about healthcare in future, what will that be?
I think given the trends over the next two decades, I would place my bets on enterprises that are focusing and prioritizing healthcare within communities and patient homes. I think it’s time that healthcare moved into that space and patients and consumers are ready to take a more active participative role in healthcare decision making
T&T: Can you give me some examples?
AG: Some examples that come to mind-tools to better manage health within communities, in terms of both primary and secondary preventive Health; tools that alert health systems on patient journeys within communities so that they can allocate their resources with a lot more data than they currently do. I think those are the kind of technologies and interventions that are poised to take off, especially in the post-COVID19 world, where digital adoption is going through the roof, patients and consumers are more concerned about going to hospitals, explosion of chronic diseases and health care and economic burden all of these things place on our healthcare systems. We can’t wait for patients to get unhealthy and hospitalized before we intervene;
I think anything that allows us to get to patients and consumers in their homes, in their communities and give them the tools to better take care of themselves and give health care workers the tools to visualize their journey is it’s got a very bright future.
T&T: and conversely, is there something that you would bet against?
AG: I think by that extension I’m not very excited about facility-based care. I know we need a lot of that-we don’t have enough surgeons, we don’t have enough intensivists. So, we do need to boost up that healthcare workforce. But I think we are not going to see exponential innovation in facility-based care, it will be more incremental. I wouldn’t say I would bet against it but it’s not the one that holds the most exciting promise for the future of healthcare.
T&T: What is your most cherished grudge in healthcare?
AG: Two cherished grudges! First one (and maybe it’s because I trained as a physician) that we don’t we don’t give doctors their due; in many instances, we want them to be to be almost like angels, you want them to do to work very hard, but we sort of grudge them the returns of the work that they take back, that I think is inappropriate. We need to find a balance where we are obviously expecting doctors to do the right thing, but you don’t grudge them, for the rewards that they take back home and I mean financially and socially.
The other grudge that I have is that while in the last 10 years, there’s been a lot of conversation around empowering patients and, thinking about user-centred solutions and patient centred solutions. I think there’s a lot of intellectual conversation around that theme, but I think it’s still notional. I think as an industry and as multiple stakeholders, we still take a very paternalistic approach to health care, whether its policy makers or governments or industry. So, I do feel that letting go of that paternalistic approach is going to be tough, but we need to move from just paying lip service to patients centred solutions to actually getting patients at the centre of solution design.
T&T: I actually get quite worked up with all the talk and no action about patient-centricity in many places.
AG: Yeah, and you know, you can see why that happens; in most organizations, you’ll have one conference in a year where they bring in a patient, they will talk about his or her journey and then the entire audience will be teared up. And I’m glad that even large organizations are doing that because they’re trying to stay connected with what it means to go through a patient journey so I don’t begrudge that but I think we need to move beyond that. We literally need to ask ourselves what the patient would expect in every strategic conversation that happens within large organizations. And that means shifting the DNA, changing thought processes, getting one more stakeholder around the table, a table that’s already very crowded within Healthcare.
I feel there are two extreme elements here-either healthcare decision makers take a completely distant view of solutions, they look upon it as managers, as bureaucrats, as paternalistic decision makers so that’s one end of the spectrum; the other end of the spectrum is very often I see healthcare policy makers make decisions based on their personal experiences and while those personal experiences are rich, it’s not enough to use them for advising policy; I think we need to find a way to get more rounded patient-centred feedback and take a more objective view of what needs to be done.
T&T: I want to end with something that I get asked quite a lot from technology entrepreneurs-why should they think about working in healthcare, considering the long time to ROI, the many complexities etc?
AG: That’s a great question and thanks for asking that; I think the only thing I can come up with is it depends on how you want to measure your ROI, right? One way of measuring ROI is financial and it is no secret that you are working in healthcare, if you are starting a business in healthcare or training to be a healthcare professional, the horizon for success or whatever is considered as markers of success is certainly much further out than it might be for retail or e-commerce or banking. I think it gets there but takes maybe more time as compared to other sectors.
But there’s also the intellectual ROI-the biggest challenges in the world are in sectors like healthcare- the biggest inequities in the world are in sectors like healthcare; it constitutes one of the biggest expenditures that all of us are bearing out of our pocket; so, it’s a question of you know, where you want to be challenged.
So, if you start doing a triangulation of where you get the intellectual ROI, the Spiritual ROI, and Financial ROI then I have to say that healthcare has to be one of the best.
Some of the smartest and the wealthiest people in the world are taking up the healthcare challenge and that should be an indicator of the intellectual gratification that one could get by working in healthcare.
I think that would be my pitch for somebody starting/restarting in healthcare.
