Where's the Porn in Healthcare?

Yes, I am talking about pornography. No, I’m not going to be discussing the role of sexual therapy in healthcare. This is about innovation.

These articles from The Atlantic and Business Insider are old but good. They discuss how porn has long been the driving force of innovation in technology, both system wide level and at an individual level as people upgrade their technology in order to meet their…requirements. And they continue to innovate their industry in surprising ways (there’s an interesting example about how Huggies uses technology developed by the porn industry in the BI article).

We wouldn’t have the internet as it is today without pornography. Not because they invented it (they didn’t) they just made effective use of the technology and pushed the boundaries of what was possible. They were, and continue to be, early adopters maintaining a focus on consumer experience.

This is a good example of the theory of diffusion of innovation in action, originally talked about by E.M. Rogers in 1962 and made famous in the technology world through Geoffrey Moore inCrossing the Chasm, the book about how technology innovations become mainstream or die (around 90% of tech startups fail even when backed by venture capital). Here’s a less than a minute video summary

These same challenges are faced in healthcare, we just use different terms like “translation of research into practice” and “implementation science” which make it sound a bit more fancy and academic. Of the evidence based innovations that actually make it into practice, its said to take an average of 17 years for them to be adopted at scale.

Think about where society was 17 years ago…yeah, I think it’s fair to say the context has changed a bit since then. So how can we do better?

I think we could start by thinking about where the healthcare equivalent of the porn industry might be. The segment that is so focused on meeting consumer needs that they’ll push the limits beyond that which is acceptable to most of society.

I’m going to go out on a limb and say that I think I’ve finally found a positive use for Pete Evans and the other snake oil traders. They are our porn industry. They push the limits beyond that which is acceptable, and in doing so they show us where the edges are. We might not like their methods. We might think their subject matter is somewhat unsavoury at times. But the fact remains that they are meeting their people where they are, serving their needs and wants and building a loyal tribe of raving fans who will buy whatever they are selling.

The general wellness industry are taking full advantage of this boundary pushing. It helps position them as “not as crazy as Pete Evans” which makes them feel much safer for more conservative people. This has enabled the wellness industry to cross the chasm into the mainstream. Think about it. How many people do you know that use essential oils, take supplements, follow a specific diet, talk about mindfullness and relaxation techniques…I bet a lot of these people are just average people. And a lot of those working in the wellness industry are average (and ethical) too.

So how can we apply some of these principles to advancing evidence based innovations? I think a lot of it lies with those of us who are providing the care. We need to take responsibility for developing our skills and competency in taking evidence based innovations and turning them into a working reality in a way that doesn’t include bashing people over the head with studies or using phrases like “the evidence tells us”. Rather, I think we need to get better at understanding what the people we serve need and want. Find the innovations that could meet those needs and wants and develop service models and business models that can deliver it in a way that those people will willingly accept. Build healthcare services that they’ll tell other people about.

We should feel pissed off that Pete Evans is better than us at this. It’s ok to resent his success and feel disdain toward him over the power he yields so recklessly. But we shouldn’t fool ourselves that the only thing holding us back from making equivalent impact (in our case positive impact) is ethics. We need to take responsibility and do better.

But maybe I’m wrong…if so I’d be happy for you to tell me about it! Sign in or sign up and reply below so we can talk about it and explore different perspectives on the issues.

If reading this has sparked your interest in any way, please share it. Email it to a friend or link to it on social media. We’re not going to advance practice and innovate in healthcare if we don’t start taking action, but that action doesn’t always have to be big.

And if you’ve enjoyed reading this, check out some of our other #learn-always:podcast-of-the-week topics. Some of the ones around value in healthcare might be a place to start, like Dogs, drill bits and medicine or Slow medicine