"There was an idea to bring together a group of remarkable people, to see if we could become something more.” – Nicholas Joseph "Nick" Fury, Agent of S.H.I.E.L.D.
(Doximity)
In many ways, this inspirational statement from a leading Avengers character deeply resonates with me. As a doctor and member of the healthcare business community, I have dedicated most of my years to a greater cause, joining a team of committed professionals that share a collective desire to improve people’s lives.
But how each of us achieves this objective is another matter. As an “Avengers: Endgame” and Marvel fan, I couldn’t help but see a reflection of the function—and dysfunction—of our imperfect system in the hit series of movies.
Here is my take on a few characters that mirror key players in healthcare and what the industry can learn from these beloved characters’ story lines. For those who have not yet seen “Avengers: Endgame,” rest assured—there are no spoilers. However, the movie has been out for several weeks now, … so that’s on you.
Physicians remind me of Captain America as we take on a duty that is rooted in a promise: to uphold the Hippocratic oath (first, do no harm). We always do our very best to serve all of our patients at any cost, at all times. However, physicians often feel pulled in different directions by external forces. Whether it comes from ever-evolving regulatory requirements or the obstacles created in documentation woes, physicians in America are facing record levels of burnout. These myriad factors makes it challenging for physicians to practice medicine.
Senior executives in the business world need to remember that the medical professionals on the frontlines of patient care always put the patient first; any new technology or service must do the same. Companies such as Doctor on Demand, One Medical and GoodRX are shining examples in the private sector that are doing just that.
In Tony Stark, I see technology. And sometimes, technology companies can lose sight of the actual mission and get carried away, missing the mark altogether. Think back to the CEO of Theranos, Elizabeth Holmes. Some may disagree, but I believe her intentions were good. She was driven by her passion to help save lives through an innovative blood testing system. Once named the youngest and wealthiest self-made female billionaire in America, Holmes’s company no longer exists and she has been charged with “massive fraud” for false and exaggerated claims about the accuracy of her blood-testing technology.
Experts have used Theranos’ downfall as a shining example of why Silicon Valley’s “fast fail” approach doesn’t work for health tech. This is a lesson worth punctuating. There is a reason healthcare is highly regulated and controlled—people’s lives are at stake, and there is no room for error. I encourage all innovators and entrepreneurs to keep this in mind.
As you build your business, surround yourself with the experts who know your space inside and out—much as S.H.I.E.L.D. did for Stark with the Avengers. As much of a savant as Stark was, he is still only one human. Stack your board with clinical and technical experts who will always know more than you ever could in their particular specialties. While that board might not get you sky-high valuations and unicorn status, they will likely help you avoid fraud and other criminal charges because your product or service doesn’t work in the real world.
Government and legislation mirror The Hulk. For the most part, Dr. Bruce Banner—the Hulk’s normal, human self—does good work and flies under the radar. But that calm is erratically punctuated with a dramatic overreaction that can level metro areas to the ground, and it can then be extremely hard to contain The Hulk, leading to unnecessary disruption (or destruction).
While legislation is largely rooted in the desire to improve the lives of its citizens and is extremely calculated like Dr. Banner, it can be hard to manage or predict. Healthcare business owners, particularly those that look to scale across the country, regularly cite the complex web of healthcare regulations—both federal and state—as challenges that can hinder growth.
When you add a layer of uncertainty, this further complicates matters. Remember the months when the Democratic and Republican parties battled it out for the Affordable Care Act vs. the American Health Care Act (AHCA)? It sent healthcare indices into a tailspin. And we are seeing it happen again with “Medicare for All.”
Unfortunately, there are no magic words of wisdom or a silver bullet solution for navigating these changes. You should always expect dramatic peaks and valleys interspersed between long plateaus. Business leaders must remember that “this too shall pass” and avoid knee jerk reactions. Do not allow external changes beyond your control derail you from your mission.
Black Panther represents the think tanks and the industry hopefuls that put our healthcare system into perspective, reminding us of what our country could be if we modeled ourselves after other successful health systems. In Black Panther’s home country, Wakanda, they have harnessed technology to its full potential in medicine: virtual reality coupled with diagnostic imaging empowers irrefutable diagnoses, head-up displays can constantly monitor a patient’s vitals, Kimoyo beads serve as communication devices and health monitors, nanorobotics quickly cure patients, etc.
While the film attributes Wakanda’s “medical utopia” to a fictional precious metal, it also credits the nation’s existence to its smaller size and ability to stay hidden beneath a force field. Needless to say, this is not a reality for the U.S., but organizations such as the Institute for Healthcare Improvement and Haven Healthcare are trying to fundamentally change the way we think and practice healthcare across the country. The key to their success (or anticipated success) is that they are committed to looking beyond the status quo and thinking creatively about ways to achieve high levels of quality in care while lowering costs.
A huge player in “Avengers: Endgame” that almost always seems to be forgotten are the innocent civilians—which in healthcare, are the patients. In the battle of New York, the entire city is destroyed and innocent lives are taken. Let’s not forget: As entrepreneurs and business executives in healthcare, we cannot overlook the patients.
In the end, each hero’s mission really distills down to two players: the patient and the doctor. The patient who needs access to high-quality healthcare and the physician who administers that care. No matter what your healthcare business may be, it’s important to always keep the patient and the physician top of mind, or else we will lose sight of the bigger picture and our version of the supervillain Thanos may win.
Amit Phull, M.D., is a self-confessed geek when it comes to the Avengers. He is also medical director and vice president of strategy and insights at Doximity.