Blue Oceans for Health? Kind of a strange name, huh? After coming up with the name (and, of course, prematurely securing the naming rights), I realized there are two issues with the name that could make it problematic for the blog’s newcomers. For those readers unacquainted with the management sciences, the name is likely to be incomprehensible at first read. On the other hand, for the strategy mavens out there I am afraid the “blue oceans” referred to may be less intellectually rigorous than what you’re hoping. If I’ve sufficiently disappointed both ends of the knowledge spectrum, my hope is that there is a sweet spot of blog readers who can appreciate the meaning behind the blog’s name without becoming obsessed with a strict interpretation of its underpinnings.
For the Uninitiated (My apologies to experts for any oversimplification)
In 1997, Chan Kim and Renée Mauborgne published an article in the Harvard Business Review, “Value Innovation: The Strategic Logic of High Growth,” that initiated a challenge by the authors to traditional structuralist approaches to management strategy. “Strategy” in the management sciences is the part of running a business that is concerned with how one succeeds against business competitors. In other words, it doesn’t matter if a company sells the greatest toaster in the world if it is not able to use its relative strengths to outcompete other sellers of toasters. For decades, most academics have argued for some variation of a structuralist approach where’s one competitive position in the industry relative to other firms is what determines one’s strategy. Michael Porter (and his Five Forces model) has been one of the most prolific and best-known proponents of such a positioning approach (to the point that a strategy professor of mine at Saïd once remarked that to get something published in strategy basically means its got to out-think Porter).
Kim and Mauborgne had such an impact because they argued that the debate is not about industry structure but about how a firm remakes an industry to make it strategically advantageous. This reconstructionist approach they advocated was ultimately named a “blue ocean strategy.” The basic premise is that the majority of industries in their present form are highly competitive and hold increasingly homogenous products. Competing in such an environment makes a “red ocean” where competitors become increasingly aggressive which leads to a bloody ocean with only marginal success. In contrast, “blue oceans” represent currently unknown markets that are available for entry by the firm but often not yet identified by competitors. One of the most successful firms at employing a blue ocean strategy is Nintendo who has continued to re-invent itself as it brings new products to market that change the nature of by whom and how video games are played.
and…What’s with the name?!
My personal view of the healthcare industry today is that we are too confined to competing in and thinking about the same red oceans. For us to find ways to deliver better care at reasonable costs, we need to look beyond the products, services, and ideas that have largely created the current mess. Rather than using the term “blue oceans” to discuss business strategies, I am adopting the term here to mean thinking about healthcare problems and brainstorming solutions that explore new frontiers of healthcare. Blue Oceans for Health is designed to be an online space that evaluates new concepts for better healthcare by analytically asking how these proffered solutions are different from the current paradigm and what advantages they bring.
Who am I? What a most excellent question. Unfortunately, it’s not an easy one to answer.
Warning: This post may get too theoretical and off-issue for the casual blog reader. Alternatively, those looking for the highlights, please see my CV.
To the casual observer, I certainly understand how he undergraduate political scientist, Teach For America alumnus, accused medical school “gunner“, and possibly European MBA “corporate shill” may come off a bit disjointed. I would argue that from the right point of view, my professional career-to-date has been a systematic evolution of personal development as I try to reconcile an overwhelming inner desire to serve others with the practical life questions of career choice and personal fulfillment.
I was fortunate to attend a high school that recognized its role as a resource to the surrounding community and made community service a central tenet of its teaching philosophy. Throughout these formative years, I was actively involved in my high school’s community service program ultimately being given an opportunity to shape the greater community service effort of the school.
Although I greatly enjoyed the sort of “hands-on service” I did in high school, college forced me to realize that I ultimately would need to find a profession that helped me serve others while also addressing the practical demands of life. At the time, I was intensely interested in policy work believing that the underlying problems of society could be solved through properly implemented, innovative public policy efforts. This thinking led me to become involved with and ultimately become Publisher of the campus’ political thought magazine as well as focusing my independent work (search “leeds”)on designing political institutions that improved the health and wellbeing of the entire society rather than a select few.
As I became more knowledgeable on the role public policy takes in service to others, I started to question whether the sort of indirect effects and limited success of that role satisfied my sense of moral obligation for serving others. Reevaluating future career options is what led me to complete a pre-med curriculum in addition to my social science major because of the ability of a physician to have a direct, positive effect on each patient seen.
Additionally, I realized I needed to better understand the communities and individuals that I intended to serve. I was fortunate enough to be able to defer my acceptance to Emory’s School of Medicine to spend two years as a corps member with Teach for America where I taught high school science in an underserved community in Memphis, TN. This experience was fundamental to shaping my understanding of how one could both lead a life of hands-on service while at the same time leading an organization whose reach spread across hundreds of communities through the United States.
Upon arriving at Emory, I immediately jumped at the opportunities before me to combine my interest in medicine with my past service work. I became heavily involved with Emory Medishare, a student group dedicated to improving the health and wellbeing of the people of Haiti’s Central Plateau region. What has drawn me to international health over the years is the overwhelming need for even the most basic of humanitarian aid. The five trips I have made to date – and those I will make in the future – to Haiti have convinced me of the necessity of our work there.
My role as the group’s Executive Director was to find ways for our work to become a self-sustaining, permanent presence in rural Haiti. We radically expanded our program from a once-a-year presence with our local partners to a cycling of short-term trips and longer-term electives that continue today. These efforts serve as vehicles for clinical research that had led to new health interventions such as community nutrition programs and mental health screening.
Another of Emory’s shining gems is the Global Health Institute. In September 2009, the academic center offered me a position on their Student Advisory Committee that runs the Institute’s student-centered events like the annual Health and Development Symposium and Global Health Case Competition. For the 2010-2011 academic year, I served as chairman of the committee as we continued to develop an independent role within the greater Global Health Institute. Being able to engage such a diverse group of students and faculty involved with interdisciplinary global health work at Emory as been intellectually exhilarating. The Global Health Institute and Emory Medishare have both been formative elements of my Emory experience and have focused the sort of service work I hope to do after I graduate.
It was exactly in this context that I elected to take an additional year to pursue a second degree while in medical school. While extending medical school by a year for an additional degree is not uncommon, choosing an MBA is one of the more unusual degrees of those on offer. The rationale in pursuing the MBA largely overlaps with many of the interests I explore in this blog. Organizational leadership, operations and implementation, and decision-making under scarcity are real healthcare problems that other degree programs (e.g., MPH, clinical research degrees) are not designed to address. Because my interest in business school lay outside of the mainstream, I purposefully sought out a program structured enough to provide me with the resources I need but still flexible enough that I could forge my own path. At the University of Oxford’s Saïd Business School, I found the right balance for me. The school’s former dean summed it up perfectly when he described Saïd as a place that can “transcend the traditional, functional divisions of a business school in order to address the complex challenges facing business in the twenty-first century.”
My primary career goal is to remain grounded as an academic clinician in the U.S. while pursuing research and advisory roles with organizations dedicated to improving access to surgical care in under-resourced areas of the world. This academic space desperately needs clinicians who understand the administrative capacity needed for organizational changes. With my combined training, I hope to be able to provide the degree of balanced expertise called for.
Still not following (or not buying) my career trajectory? I recently re-watched Steve Jobs’ Stanford commencement speech he gave in 2005 recently after recovering from his first cancer diagnosis. As one of the YouTube viewers noted, the content isn’t just advice for Stanford graduates but a blueprint for how Jobs led a life that he found so personally fulfilling. The most memorable piece of the speech for me was the following:
So you have to trust that the dots will somehow connect in your future. You have to trust in something — your gut, destiny, life, karma, whatever. This approach has never let me down, and it has made all the difference in my life.
Every day I wake up knowing that I am going to be faced with countless decisions. While most decisions will have minimal lasting effect, I know that a handful have the potential to have world-changing consequences for me. I’ve done my best to trust my gut and choose the next “dot” wisely.
Ira Leeds
Blue Oceans for Health 