Health Innovation: lessons from the past

What lessons can innovators learn from the experience of a medical practitioner born in 1749? Here is a summary of what happened:

  • He was a curious and prodigious innovator who based his ideas on his observations.
  • He built and twice launched his own hydrogen balloon.
  • He published the observation that it is the cuckoo hatchling that evicts the eggs and chicks of the foster parents from the nest. Something that many naturalists in England dismissed as pure nonsense until it was proven beyond doubt in 1921.
  • He devised an improved method for preparing a medicine known as tartar emetic (potassium antimony tartrate).
  • He worked as a doctor and noted that dairymaids were protected from smallpox naturally after having suffered from cowpox.
  • In 1797, he sent a case report to the Royal Society describing how a boy who had been inoculated with cox pox subsequently became immune to small pox. The paper was rejected.
  • Many years later he published another paper outlining his hypothesis. The publication of the Inquiry was met with a mixed reaction in the medical community.
  • In the course of his life he not only received honors but also found himself subjected to attacks and ridicule.

In summary 80% of people exposed to small pox contracted the disease. Almost 1-7 died. Many thought it was innate to humans. Others thought it was an infection attributed to menstrual blood or something caused by the putrefaction of the umbilical cord. A host of remedies were proposed at the time, including special diets and enemas. ┬áThere is a remarkable parallel between the variety of proposed “cures” for smallpox and the treatments for many modern maladies foisted on a long suffering public by those looking to make a profit. The discovery of the small pox vaccine by Edward Jenner was arguably one of the greatest leaps in medical science. It was made by someone who observed the effect of the innovation at first hand. His ideas were rejected and ridiculed by many but recognised by those with sufficient insight to ensure that humankind would benefit for generations to come. How do we recognise those most likely to offer a genuine step forward in our search for a better way?

Health innovations are not always intuitive, but rather are made by innovative thinkers who are brave enough to try something new and think outside the box. Colin Farrelly

My colleague Ori Gudes drew my attention to this post by Chris Dixon. Chris brings the Jenner experience into the 21st Century. His post outlines three key features of those with a winning idea:

  1. Know the tools better than anyone else
  2. Know the problems better than anyone else
  3. Draw from unique life experience

However, having said that he points out that these characteristics are not immediately successful in getting their innovations to market because:

  • Powerful people dismiss them as toys
  • They unbundle functions done by others.
  • They often start off as hobbies.
  • They often challenge social norms.

So how do you spot a good idea? Pose one question: Does the founder have technical expertise, problem/domain expertise or experience? My colleague Oksana Burford and I observed the reaction of young women who were shown photoaged images of their wrinkled faces after a lifetime of smoking. What we observed persuaded us that this reaction would trigger determined attempts to stop smoking. Despite numerous applications Oksana couldn’t get her project funded. Potential funders couldn’t see what we had witnessed in the consulting room. So she committed to it as a self funded PhD. Oksana delivered the intervention as part of brief professional smoking cessation advice in a randomised controlled trial. As per the published results we observed 1 in 7 successful quit attempts, which is better than most other interventions. Oksana will soon be working with colleagues targeting Parisian smokers. Meanwhile Gemma Ossolinski and I are using a similar intervention in obesity– the preliminary results are also very encouraging.

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