• by Prodeep Bose , Columnist, September 23, 2014

Of late, I’ve found myself staring into a few large contradictions that impact my professional world and thinking about the opposing forces they represent. For example:

True: Pharma creates value through products that drive better outcomes. 

Also true: Pharma revenue is driven by volume of product used, not outcomes.

True: Social and mobile applications for health management offer a game- changing opportunity. 

Also true: Health apps are most adopted by healthy, proactive people and least adopted by those who need them most. 

True: Agencies create value by generating ideas. 

Also true: Agencies are compensated on the basis of time billed to clients, not the success of their ideas.

Equal and opposing forces define the nature of our experience; Newton’s third law, the Manichaean view of the duality of light and darkness and the Dalai Lama’s discourse on the Middle Way approach to conflict resolution all point to approaches in understanding contradictions and finding confluence.

Perhaps more approachable examples of this phenomenon are popular terms like “frenemies” and “coopetition” — terms used to describe the relationship among Facebook, Google, and Apple, or the characters in “Sex and the City.” The fact is frenemies drive evolution – be it personal or professional.

Scenarios that find confluence within contradictions

The central premise in the resolution of opposing forces seems to be to find a confluence of interests and align opposing forces toward a mutually beneficial/acceptable end. In applying that filter to the contradictions in healthcare, we arrive at points of confluence that suggest surprising opportunities.

What if…payers paid pharma on the basis of health outcomes achieved and consequent cost savings through the use of their product instead of the volume of product purchased? Pharma would invest in supporting care and managing compliance just as they do during a clinical trial and go beyond product-based selling to a patient-centric outcomes focus.

What if…healthcare companies were to make capital investments in startups that focus on health-technology innovation and fund them, just as a venture fund would, without absorbing them into the organization? This would allow companies to participate in a high-risk, high-growth area that hedges against low growth while staying aligned to the overall healthcare mission of better disease management. The future would be hedged against profit based on product development alone in high-cost, low-incidence disease categories while fueling innovation in improved healthcare management.

What if…agencies were compensated like employees—with a base and bonus on sales objectives achieved instead of hours billed? Agencies would be invested in the business outcomes of their clients and not just in fame, and clients would only pay when they win.

In healthcare and elsewhere, contradictions are not to be resisted but embraced. We will all benefit.